C.D.C. Investigating 14 New Reports of Zika Transmission Through Sex

Health authorities in the United States said they were investigating 14 new reports of the Zika virus possibly being transmitted by sex, including to pregnant women. If confirmed, the unexpectedly high number would have major implications for controlling the virus, which is usually spread by mosquito bites.

Scientists had believed sexual transmission of Zika to be extremely rare. Only a few cases have ever been documented. But if all the women in the cases the Centers for Disease Control and Prevention is examining test positive for the virus — as two women already have, and four others have done in preliminary lab tests — officials believe there is no way other than sex that they could have contracted it.

The specter of so many cases — all in the continental United States — brings fresh complexity to the medical mystery of Zika. The virus is suspected to cause birth defects and a rare condition of temporary paralysis.

“We were surprised that there was this number,” Dr. Anne Schuchat, the deputy director at the C.D.C., said in an interview. “If a number of them pan out, that’s much more than I was expecting.”

In all the cases the C.D.C. is examining, women in the continental United States had sex with men who had traveled to countries where the virus is circulating, and developed symptoms associated with the virus within about two weeks of their male partners’ symptoms.

Officials at the C.D.C. reported the potential cases in an alert to health care providers on Tuesday.

The agency did not say exactly how many of the women were pregnant, but it reiterated its recommendation that people returning from Zika-infected areas use condoms or abstain from sex for the duration of their partner’s pregnancy. The alert said there was no evidence that women could transmit Zika virus to their sex partners, but added that more research was needed to be sure.

This country has become a laboratory of sorts to test the sexual transmission of Zika, as scientists race to understand the disease. Transmission by mosquitoes is not yet happening in the continental United States because it is still winter, so health officials say they believe that any infection of an American resident who has not traveled to a place where Zika is circulating has probably been contracted through sex.

“In the U.S., where most people aren’t traveling to these areas, we may be able to uncover the potential risk,” Dr. Schuchat said.

In all, the United States has around 90 cases of Zika, according to the most recent count from the C.D.C., most of them contracted by people who had traveled to Latin America, currently the center of the virus. If confirmed, the new reports of sexual transmission would represent about 15 percent of that total.

“It’s beginning to look as though Zika can be more readily transmitted sexually than we first anticipated,” said Dr. William Schaffner, professor of preventive medicine at Vanderbilt University Medical School. “These data are illuminating some of the things we don’t know.”

Zika was originally identified in the 1940s in Africa. For most people, it is a relatively mild virus, causing rashes, red eyes and joint pain; many people have no symptoms at all. But the association with a condition known as microcephaly, in which babies have been born with unusually small and deformed heads to women who had Zika during pregnancy, has raised global alarms. On Feb. 1, the World Health Organization declared the virus and its link to the birth defects a public health emergency.

Questions about how frequently Zika can be transmitted by sex and how long the virus can stay in semen are particularly urgent here, given the large volume of travel between the United States and Central and South America. There were about 5.5 million visitors from South America to the United States in 2014, and nearly a million from Central America, according to figures from the Department of Commerce.

And with the season for mosquitoes — still believed to be the primary mode of infection — nearing in the United States, Tuesday’s report is likely to further complicate preparations in states across the country.

http://www.nytimes.com/2016/02/24/health/zika-virus-sexual-transmission.html?_r=0

In all, the United States has around 90 cases of Zika, according to the most recent count from the C.D.C., most of them contracted by people who had traveled to Latin America, currently the center of the virus. If confirmed, the new reports of sexual transmission would represent about 15 percent of that total.

“It’s beginning to look as though Zika can be more readily transmitted sexually than we first anticipated,” said Dr. William Schaffner, professor of preventive medicine at Vanderbilt University Medical School. “These data are illuminating some of the things we don’t know.”

Questions about how frequently Zika can be transmitted by sex and how long the virus can stay in semen are particularly urgent here, given the large volume of travel between the United States and Central and South America. There were about 5.5 million visitors from South America to the United States in 2014, and nearly a million from Central America, according to figures from the Department of Commerce.

And with the season for mosquitoes — still believed to be the primary mode of infection — nearing in the United States, Tuesday’s report is likely to further complicate preparations in states across the country.

comment: It is a given that Zika can be sexually transmitted. They have known that for  years. No one wants to see this become an epidemic - much less a Pandemic. There is no effective treatment for it and not likely to be a tested vaccine for years. So what is the solution? Tell an already struggling medical system in the U.S. to prepare to treat millions of sick people.  It is kind of like the under the tree discussion I had with a member as to what happens if Avian became airborne. If we survived we could sit under a tree and he would tell me - you know Med - you were right - damn this was and now most of the people are dead. If this disease does get really bad, it will tax an already hurting health care system and even more viruses and such will spread. Pretty gloomy for a hump day which is bad enough already don't you think?

Medclinician

The World Health Organization has drawn comparisons between the current Zika crisis and the Ebola disaster. The two situations could not be more dissimilar. Ebola was associated with an approximate 70% case fatality rate and 15,216 confirmed cases as of January 20^th for all of West Africa. Recall there was great concern at the time of virus mutation leading to a more transmissible form of Ebola. It turns out this was not the case and CDC’s forecasts of over a million cases in West Africa were not realized. Zika virus infection estimates so far are as high as 2 million cases across 18 tropical American countries, with more than 3,500 birth defects documented. Fatalities have been rarely reported among patients with sickle cell disease. Zika is impacting drastically more people than the Ebola epidemic, however without the same degree of lethality. . So, to compare Ebola and Zika is truly not appropriate: these are two very different situations.

It should also be noted that Zika was not the only Africa-origin exotic virus to recently be introduced to tropical America: Chikungunya appeared two years ago and has spread rapidly as well. Chikungunya is also an African mosquito-transmitted virus. Brazil has, to-date, reported limited data regarding the emergence of Chikungunya in their country so we do not know how many people have been impacted. Brazil’s overall public health surveillance enterprise is not as robust as other countries and they have motivations to avoid reporting outbreaks such as the recent World Cup and upcoming Olympics.Both Chikungunya and Zika have been associated with birth defects so Chikungunya deserves our attention, too.

There are some baselines here and common sense. Whether is it recently prevalent in Latin America or has been there for years i.e. they now are testing more and getting more positives - don't go for Spring vacation to infected countries and if you have a lover who does use a condom when you have sex, just like HIV.

Dr. John and I have discussed this several times and the real threat here is that it could wipe out, if widespread enough, much of the new generation. The effect on the medical care system would be devastating and Lord help us, it would effect mostly the poor minorities which have multiple children and large families and third world nations.

The only possible believable conspiracy theory on this would be that someone has developed a more virulent strain of this on purpose. This would be another example of a deliberate effort to reduce the Feeder population and immigrants which are bringing the economy in areas to its knees.

Yet currently with 6 confirmed cases are we there yet?  Not yet.

Medclinician