Gov. Scott declares Zika health emergency in four counties, including Miami-Dade

Gov. Rick Scott declared a health emergency Wednesday because of the arrival of at least nine cases of the mosquito-borne Zika virus in four Florida counties, including Miami-Dade.

Scott signed the emergency order to cover Miami-Dade, Hillsborough (Tampa), Lee (Fort Myers) and Santa Rosa (Panhandle) counties. Within the past two weeks, health officials have confirmed four Zika cases in Miami-Dade, two in Hillsborough, two in Lee and one in Santa Rosa.

All nine of the cases stemmed from residents who had recently visited Latin America and the Caribbean, were bitten by a mosquito and unwittingly brought the disease back to the state. Three cases were contracted in Haiti, three in Venezuela, two in Colombia and one in El Salvador, according to state health officials.

The Pan American Health Organization (PAHO) on Monday added Jamaica and Costa Rica to the list of 24 countries in the Western Hemisphere where the Zika virus has been detected. On Wednesday, Dr. Carissa Etienne, the director of PAHO, requested $8.5 million from the international community to help fight Zika.

“One fact of which we are unequivocally sure is that the Zika virus — like dengue, chikungunya and yellow fever viruses — is transmitted by the Aedes aegypti mosquito,” Etienne said. “The most effective control measures are the prevention of mosquito bites and the reduction of mosquito populations.”

While health officials are scrambling to contain the spread of the virus, regional tourism officials are worried about the impact it will have on the multibillion-dollar tourism industry during the crucial winter season.

“It’s a concern of everyone,” said Guadalupe Monge, a travel agent with Miami-based Costamar Travel. “I’d say 100 percent of our customers are asking about Zika. They want to know how bad it is. Is it safe to travel? Can they change their tickets?”

The Greater Miami Convention & Visitors Bureau did not return phone calls seeking comment.

Health officials are particularly concerned about how quickly Zika has spread, as the infected Aedes aegypti mosquitoes have transmitted the virus from person to person. Since first being detected in Brazil last May, more than a million people in Brazil have contracted Zika.

Zika causes relatively minor symptoms — light fever, a rash, muscle pain and conjunctivitis (red eye). It hadn’t represented a significant health issue — until the Brazilian outbreak. Zika has been linked to a rare neurological disorder called microcephaly, associated with babies being born with smaller brains that do not develop fully. The greatest risk appears to stem from an infection that develops during the first trimester of pregnancy, World Health Organization officials have said. To date, Brazil has reported more than 3,000 suspected cases of microcephaly.

Zika was long thought to be transmitted only when an infected mosquito bites a person. But health officials in Dallas on Tuesday reported a case of the virus being transmitted sexually by a person who had recently returned to Texas from Venezuela, adding to officials’ concerns.

Monge, the travel agent, estimates that her agency, which organizes trips and tours throughout the Caribbean and Latin America, has lost about 20 percent of its business as news of Zika has increased.

The timing is terrible, as Carnival season is picking up and spring break season is around the corner. Both draw tens of thousands to the region.

Caribbean public health officials launched a new public awareness and health campaign last week geared toward protecting the region’s $29 billion industry.

“We can never let our guard down where infectious diseases are concerned, and that is particularly so in our tourism-dependent Caribbean region,” Dr. C. James Hospedales, executive director of the Caribbean Public Health Agency, said at a news conference in Trinidad and Tobago, another tourist-dependent nation.

While the Centers for Disease Control and Prevention has advised pregnant women to postpone trips to infected countries, officials in those countries say others shouldn’t be dissuaded. They suggest taking standard precautions to prevent mosquito bites, including using repellant, sleeping inside and wearing long-sleeved shirts, long pants and hats.

“Don’t let the mosquito ruin your travel,” the Caribbean Public Health Agency says in a fact sheet on its website.

Zika is also driving fears about the Summer Olympics in Brazil, considered the epicenter of the Zika outbreak. Since the first case was discovered in Brazil last May, Zika has been found in more than 25 countries and territories in the Americas, plus in American Samoa and Samoa in the Pacific and Cape Verde in Africa. There have been cases in at least 11 U.S. states, including Florida.

On Tuesday, health officials in Texas announced they had identified a patient in Dallas who had contracted Zika through sex. The patient, identified as Patient 1, is the first known recent case of the virus being transmitted in the United States. Patient 1’s partner, identified as Patient 0, had recently returned to Texas from Venezuela. Dallas authorities said Patient 1 had had no other possible exposure to the virus.

“Now that we know Zika virus can be transmitted through sex, this increases our awareness campaign in educating the public about protecting themselves and others,” said Zachary Thompson, director of Dallas County Health and Human Services.

Not everyone is convinced that the virus can be transmitted through sexual contact.

Dr. George Sealy Massingill, chairman of obstetrics and gynecology at John Peter Smith Health Network in Tarrant County, called the Dallas County sexual transmission a “postulated case.”

“So far, that’s their best guess how this happened,” he told McClatchy’s Fort Worth Star-Telegram on Tuesday. “It’s hard to go back and say that A caused B.”

But the CDC has endorsed the sexual transmission theory, a possibility that raises new concerns about the potential for rapid spread of a virus that until last May had been virtually unheard-of in the Americas.

The Dallas County health department added using condoms to its list of recommendations for anyone returning from an infected area.

The CDC already recommends that U.S. doctors test newborns who show signs of the Zika virus, especially in states such as Florida, where mosquitoes are a daily nuisance.

After receiving criticism that it was moving too slowly to address the virus, the World Health Organization on Monday declared the virus a public health emergency. The declaration allows for an organized international response to give countries resources and guidelines on what measures they should be taking.

Miami Herald Staff Writer Mimi Whitefield contributed to this report.

This story was originally published February 3, 2016 at 7:25 PM with the headline "Gov. Scott declares Zika health emergency in four counties, including Miami-Dade."