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US - CDC Media Statement: CDC assisting Utah investigation of Zika virus infection apparently not linked to travel - July 18, 2016

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  • #1

    US - CDC Media Statement: CDC assisting Utah investigation of Zika virus infection apparently not linked to travel - July 18, 2016

    From: "Media@cdc.gov (CDC)"
    To: MMWR-MEDIA@LISTSERV.CDC.GOV
    Subject: CDC Media Statement: CDC assisting Utah investigation of Zika virus infection apparently not linked to travel
    Date: Jul 18, 2016 1:05 PM

    Media Statement
    For Immediate Release
    Monday, July 18, 2016

    Contact: CDC Media Relations
    404-639-3286

    CDC assisting Utah investigation of Zika virus infection apparently not linked to travel

    CDC is assisting in the investigation of a case of Zika in a Utah resident who is a family contact of the elderly Utah resident who died in late June. The deceased patient had traveled to an area with Zika and lab tests showed he had uniquely high amounts of virus?more than 100,000 times higher than seen in other samples of infected people?in his blood. Laboratories in Utah and at the Centers for Disease Control and Prevention (CDC) reported evidence of Zika infection in both Utah residents.

    State and local public health disease control specialists, along with CDC, are investigating how the second resident became infected. The investigation includes additional interviews with and laboratory testing of family members and health care workers who may have had contact with the person who died and trapping mosquitoes and assessing the risk of local spread by mosquitoes.

    A CDC Emergency Response Team (CERT) is in Utah at the request of the Utah Department of Health. The team includes experts in infection control, virology, mosquito control, disease investigation, and health communications.

    ?The new case in Utah is a surprise, showing that we still have more to learn about Zika,? said Erin Staples, MD, PhD, CDC?s Medical Epidemiologist on the ground in Utah. ?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.?
    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 a laboratory exposure.

    Since early 2016, CDC has worked with state, local, and territorial public health officials to protect pregnant women from Zika infection, through these activities:

    ? Alerts to pregnant women to avoid travel to an area with active Zika transmission, to women in these areas to take steps to prevent mosquito bites, and to partners of pregnant women to use a condom to prevent sexual transmission during pregnancy.
    ? Development and distribution of PCR and IgM testing kits to confirm Zika virus infection.
    ? Establishment of CDC Emergency Response Teams to rapidly deploy to assist with Zika-related preparedness and response activities in the United States.
    ? Deployment of experts to assist in enhancement of mosquito surveillance and testing.
    ? Collaboration with FDA, blood collection centers, and other entities in the public and private sectors on enhancement of surveillance of blood donations.
    ? Guidance to prevent sexual transmission, particularly to women who are pregnant.
    ? Guidance for clinicians on the care of pregnant women who may have been exposed to Zika.
    ? Studies in collaboration with Brazil, Colombia, and other countries to better understand the link between Zika infection and birth defects, including microcephaly.

    For more information about Zika: http://www.cdc.gov/zika/.
    Tags: None
  • #2
    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/p...ito-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



    Posted by Utah Department of Health - News at 10:01 AM

    http://udohnews.blogspot.com/2016/07/public-health-officials-investigating.html
    http://udohnews.blogspot.com/2016/07/public-health-officials-investigating.html





    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment

    • #3
      A mysterious case of Zika raises new fears of person-to-person transmission

      Melissa Healy
      July 18, 2016

      In late June, an elderly Utah resident who had visited a country where the Zika virus was widely circulating died. Lab tests showed the patient, who suffered from other medical conditions as well, had a viral load more than 100,000 times higher than that usually seen in people infected with Zika.

      A family member who had cared for the patient was also discovered to be infected, prompting the CDC?s investigation.
      ...
      Unlike the deceased person ? referred to by investigators as ?the index patient? ? the caregiver had not visited an area where the Zika virus was known to be circulating. Nor had the caregiver had sexual contact with anyone known to be infected with the virus.
      ...
      In recent months, researchers have learned that Zika virus lingers in blood, semen, saliva, urine and breast milk and could, in principle, be transmitted through any of those fluids. Just last week, researchers documented a case of sexual transmission in which a Zika-infected woman infected her male partner.

      Still, no one is certain that the list of potential transmission sources is complete. Nor do researchers know whether the Zika virus is robust enough to stay alive in, say, tiny particles of saliva that might linger in the air after an infected person has breathed, coughed or sneezed.
      ...
      It is still unclear whether the index patient?s high level of infection was the cause of death or whether the patient?s immune system was compromised by other medical problems, allowing the virus to replicate uncontrollably.
      ...

      A mysterious case of Zika raises new fears of person-to-person transmission
      http://www.latimes.com/science/sciencenow/la-sci-sn-zika-mystery-utah-20160718-snap-story.html
      Experts from the Centers for Disease Control and Infection are investigating a worrisome case of Zika virus transmission after the caregiver of a Zika-infected patient who died was found to be infected as well.
      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

      Comment

      • #4
        Mosquitoes likely not to blame for unique Utah Zika case

        BY ASSOCIATED PRESS TUESDAY, AUGUST 2ND 2016
        ...
        Utah Health Department spokesman Tom Hudachko said Tuesday health workers have collected samples from more than 100 people who lived near the now-deceased father and the results have been negative, indicating the unusual transmission wasn't from the biting bugs.
        ...
        Mosquitoes likely not to blame for unique Utah Zika case
        http://kutv.com/news/local/mosquitoes-likely-not-to-blame-for-unique-utah-zika-case
        SALT LAKE CITY (AP) Utah health officials say they're still investigating how a man came down with Zika after caring for his infected father, but the results so far indicate it wasn't spread by a mosquito.Utah Health Department spokesman Tom Hudachko said
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment

        • #5
          Tuesday, September 13, 2016

          Health Officials Unable to Pinpoint Transmission Route of Zika Case


          (Salt Lake City, UT) ? Utah health officials today updated their progress on a months-long investigation into a unique case of Zika virus discovered in the state in July. The case was unique because the individual had no known risk factors for Zika virus, had not traveled to an area with Zika transmission and had no sexual contact with a person with Zika virus.

          However, health officials were able to determine the person helped provide care to another patient who was infected with Zika virus. This other patient, who subsequently passed away, was infected with an unusually high amount of virus, approximately 100,000 times higher than an average infection.

          The investigation was a collaborative effort of the Utah Department of Health (UDOH), Salt Lake County Health Department (SLCoHD), Davis County Health Department, University of Utah Health Care, U.S. Centers for Disease Control and Prevention (CDC), and local Mosquito Abatement Districts.

          To date, as part of the investigation, public health officials have tested more than 200 people for Zika virus. These individuals included family contacts of both cases, health care workers who cared for the deceased patient, and members of the general public who lived near both of the cases. No additional cases of Zika virus have been identified as part of the investigation.

          Local Mosquito Abatement Districts, working with the CDC, also trapped and tested mosquitoes around the homes of both cases. No mosquitoes from the two invasive species (Aedes aegypti or Aedes albopictus) known to carry Zika virus were found during the investigation.

          ?An important part of any public health investigation is working to identify additional cases of disease,? said Dr. Angela Dunn, deputy state epidemiologist for the UDOH. ?Finding new cases can help lead us to answers during an investigation, and while we?re happy nobody else was infected, the lack of additional cases leaves many questions unanswered.?

          The investigation has not been able to definitively identify how the case was infected. More than 2,900 cases of Zika have been identified in the continental United States and Hawaii and this is the only case that has an unknown mode of transmission.

          ?This investigation will remain active, and we will continue working to learn more about Zika virus and how it may be spread,? said Dr. Dagmar Vitek, medical director from the SLCoHD. ?People should continue to take the appropriate steps to prevent Zika virus infection ? especially pregnant women, and health care workers who are caring for severely ill patients with the disease.?

          The Utah investigation was highlighted in this week?s MMWR report, a weekly publication issued by CDC that addresses public health information and recommendations. More tips on Zika prevention are available at http://health.utah.gov/epi/diseases/zika/.

          # # #

          Media Contact:
          Tom Hudachko
          Utah Department of Health
          (o) 801-538-6232
          (m) 801-560-4649





          Posted by Utah Department of Health - News at 9:12 AM

          http://udohnews.blogspot.com/2016/09/health-officials-unable-to-pinpoint.html
          http://udohnews.blogspot.com/2016/09/health-officials-unable-to-pinpoint.html





          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment

          • #6
            Morbidity and Mortality Weekly Report (MMWR)

            CDCMMWR

            Preliminary Findings from an Investigation of Zika Virus Infection in a Patient with No Known Risk Factors ? Utah, 2016

            Early Release / September 13, 2016 / 65

            Carolyn Brent1,2; Angela Dunn, MD3; Harry Savage, PhD4; Ary Faraji, PhD5; Mike Rubin, MD6; Ilene Risk, MPA1; Wendy Garcia7; Margaret Cortese, MD8; Shannon Novosad, MD9; Elisabeth Raquel Krow-Lucal, PhD4; Jacqueline Crain2,3; Mary Hill, MPH1; Annette Atkinson, MS10; Dallin Peterson3; Kimberly Christensen10; Melissa Dimond, MPH3; J. Erin Staples, MD4; Allyn Nakashima, MD3 (View author affiliations)
            View suggested citation


            On July 12, 2016, the Utah Department of Health (UDOH) was notified by a clinician caring for an adult (patient A) who was evaluated for fever, rash, and conjunctivitis that began on July 1. Patient A had not traveled to an area with ongoing Zika virus transmission; had not had sexual contact with a person who recently traveled; and had not received a blood transfusion, organ transplant, or mosquito bites (1). Patient A provided care over several days to an elderly male family contact (the index patient) who contracted Zika virus abroad. The index patient developed septic shock with multiple organ failure and died in the hospital on June 25, 2016. The index patient?s blood specimen obtained 2 days before his death had a level of viremia approximately 100,000 times higher than the average level reported in persons infected with Zika virus (2). Zika virus infection was diagnosed in patient A by real-time reverse transcription?polymerase chain reaction (rRT-PCR) testing on a urine specimen collected 7 days after symptom onset. In addition, a serum specimen collected 11 days after symptom onset, after patient A?s symptoms had resolved, was positive for antibodies to Zika virus by Zika immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay (MAC-ELISA) and had neutralizing antibodies detected by plaque-reduction neutralization testing (PRNT). Working with Salt Lake and Davis County Health Departments, UDOH requested assistance from CDC with an investigation to determine patient A?s exposures and determine a probable source of infection.

            The investigation consisted of four components: 1) an epidemiologic evaluation of family contacts of the index patient, 2) a serosurvey of health care workers who provided direct care to the index patient before his death, 3) a community serosurvey around the locations where the index patient had resided, and 4) active vector surveillance near the residences of the index patient and patient A. For the purpose of this investigation, a family contact was defined as a person who resided in the same household as the index patient or had direct contact with his body fluids (i.e., tears, conjunctival discharge, saliva, vomitus, urine, or stool) during the period when he was most likely viremic, including a few days before his illness onset and until his death.
            Nineteen family contacts, including patient A, were identified and interviewed, and provided blood or urine specimens for testing. Thirteen family contacts reported hugging and kissing the index patient?s face. Five family contacts reported being present while the index patient?s stool, urine, or vomitus was being cleaned. Patient A reported hugging and kissing the index patient, in a similar fashion to other family contacts, and assisted hospital personnel in holding the index patient while his stool was being cleaned, but did not have direct contact with stool. Other than patient A, all family contacts were negative for Zika virus infection by rRT-PCR or MAC-ELISA on specimens obtained roughly 2?3 weeks after last exposure.

            Health care workers who provided care to the index patient and residents living within a 200-meter radius of the two homes where the index patient resided before becoming hospitalized were interviewed to assess risk factors for Zika virus infection and were offered Zika virus testing. As of August 22, 86 health care worker contacts have been identified and interviewed to assess types of patient interactions and to quantify level of exposure to the index patient?s body fluids. A total of 238 households were approached, and all available and consenting household members were interviewed using a standardized questionnaire about risk factors for mosquito-borne transmission. All health care workers and community members who provided blood specimens are being tested for Zika virus IgM antibodies using a MAC-ELISA. Urine specimens were also collected from any persons who reported Zika virus-like symptoms in the 14 days before their interview. Testing is incomplete, but as of August 22 it has not revealed any persons with Zika virus infections.

            Local mosquito abatement districts worked in collaboration with vector entomologists from CDC to conduct larval and adult mosquito surveillance near the index patient?s and patient A?s residences. Door-to-door surveys around neighborhood homes were conducted and a variety of mosquito traps (e.g., Biogents Sentinel, gravid, light traps baited with carbon dioxide, and ovitraps) were deployed. Larval specimens obtained in the field were reared to the adult stage for identification. Adult mosquitoes are in the process of being identified and tested for Zika virus RNA by rRT-PCR, but no Aedes aegypti or Aedes albopictus mosquitoes have been identified as part of this investigation.

            It remains unclear how patient A was infected; however patient A was known to have had close contact (i.e. kissing and hugging) with the index patient while the index patient's viral load was found to be very high. Although it is not certain that these types of close contact were the source of transmission, family contacts should be aware that blood and body fluids of severely ill patients might be infectious. Given recognition of high levels of viremia during illness, it is essential that health care workers continue to apply standard precautions while caring for all patients, including those who might have Zika virus disease (3).


            Acknowledgments

            Jeanmarie Mayer, MD, Sankar Swaminathan, MD, University of Utah Hospital; Dagmar Vitek, MD, Tara Brunatti, MSN-PH, Andrea Price, RN, Andrew Dibb, MPH, Salt Lake County Health Department, Utah; Bryan Burk, Utah Public Health Laboratory; Greg White, PhD, Salt Lake City Mosquito Abatement District, Utah; Ryan Lusty, Magna Mosquito Abatement District, Utah; Brian Hougaard, Eric Gardner, MSc, South Salt Lake Valley Mosquito Abatement District, Utah; Gary Hatch, Mosquito Abatement District Davis, Utah; Bryan Christensen, PhD, Scott Fridkin, MD, Marvin Godsey, Jr., MS, Susan Hills, MBBS, Nina Johnson, Amy Lambert, PhD, Kathy Seiber, MS, Ian Williams, MD; the Emergency Operation Center?s Zika Virus Response, CDC.
            Corresponding author: Carolyn Brent, cbrent@slco.org, 385-468-3918.


            1Salt Lake County Health Department, Salt Lake City, Utah; 2Public Health Associates Program Office, The Office for State, Tribal, Local and Territorial Support, CDC; 3Utah Department of Health; 4Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 5Salt Lake City Mosquito Abatement District, Salt Lake City, Utah;6University of Utah Hospital, Salt Lake City, Utah; 7Davis County Health Department, Clearfield, Utah; 8Division Of Viral Diseases, National Center For Immunization And Respiratory Diseases, CDC; 9Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 10Utah Public Health Laboratory, Taylorsville, Utah.


            References
            1. CDC. Zika virus transmission and risks. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. http://www.cdc.gov/zika/transmission/index.html
            2. Lanciotti RS, Kosoy OL, Laven JJ, et al. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis 2008;14:1232?9. CrossRefPubMed
            3. CDC. 2007 guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Atlanta, GA: US Department of Health and Human Services, CDC; 2007.http://www.cdc.gov/hicpac/2007IP/200...ecautions.html



            Suggested citation for this article: Brent C, Dunn A, Savage H, et al. Preliminary Findings from an Investigation of Zika Virus Infection in a Patient with No Known Risk Factors ? Utah, 2016. MMWR Morb Mortal Wkly Rep. ePub: 13 September 2016. DOI: http://dx.doi.org/10.15585/mmwr.mm6536e4.


            Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.
            References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.
            All HTML versions of MMWR articles are generated from final proofs through an automated process. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version (http://www.cdc.gov/mmwr) and/or the original MMWR paper copy for printable versions of official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
            Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
            ...

            http://www.cdc.gov/mmwr/volumes/65/w...cid=mm6536e4_w
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment

            • #7

              Case Report: Fatal Zika Virus Infection with Secondary Nonsexual Transmission (Correspondence, NEJM, September 28, 2016)

              Case Report: Fatal Zika Virus Infection with Secondary Nonsexual Transmission (Correspondence, NEJM, September 28, 2016) - FluTrackers News and Information
              https://flutrackers.com/forum/forum/research-about-zika-virus/761280-case-report-fatal-zika-virus-infection-with-secondary-nonsexual-transmission-correspondence-nejm-september-28-2016
              CORRESPONDENCE Fatal Zika Virus Infection with Secondary Nonsexual Transmission September 28, 2016DOI: 10.1056/NEJMc1610613 Article (http://www.nejm.org/doi/full/10.1056/NEJMc1610613#t=article) Metrics (http://www.nejm.org/doi/full/10.1056/NEJMc1610613
              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

              Comment

              • #8
                Potential new method to contract Zika virus leaves questions unanswered

                Published on October 13, 2016 at 1:03 am
                Last update on October 13, 2016 at 1:09 am
                BY SUNNY KIM

                The Utah man who contracted the Zika virus by touching his dad?s tears and sweat was an extremely rare case, according to recent research published in the New England Journal of Medicine.
                ...
                ?There is the possibility that this individual has a set of genes that made him more susceptible to [Zika] infection,? molecular biosciences professor Jaquelin Dudley said in an email. ?His son may have inherited some of those genes from his father, and he also would be more susceptible to [Zika].?
                ...
                Public health sophomore Katie Na said there should be more precautions to test the Zika concentrations in an infected person to avoid these instances from occurring.

                ?If they are going through any therapy or taking medications, these could possibly allow the virus to replicate more easily,? Na said.
                ...

                404 Not Found
                http://dailytexanonline.com/2016/10/13/potential-new-method-to-contract-zika-virus-leaves-questions-unanswered
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

                Comment

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