In the aftermath of Miami-Dade’s Zika outbreak, a team of physicians from the University of Miami Health System has published a case study detailing the country’s first locally transmitted case of the mosquito-borne illness in a local pregnant woman.
In the study that appeared Wednesday in the New England Journal of Medicine, the multi-disciplinary team described a skin rash that appeared on the 23-year-old Miami-Dade woman’s chest, arms, legs, palms and soles. This rash, along with a fever that preceded it and joint pain that followed it, ultimately led the woman to seek medical help in July when she was 23 weeks’ pregnant.
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The medical team followed the woman through her pregnancy, which provided a rare glimpse into the skin manifestations of the virus. The woman eventually delivered a full-term infant, who tested negative for Zika.
Health officials are most concerned about pregnant women contracting Zika, as the virus is a known cause of microcephaly, a neurological condition that causes babies to be born with smaller heads and incomplete brain development. The infant’s head size fell within the normal range, the study said.
Zika patients don’t always present with a skin rash, said Dr. Lucy Chen, a Jackson Health dermatology resident and lead author of the study. So the opportunity to follow the patient and report on symptoms will help both physicians and others recognize what a Zika virus rash might look like.
“We wanted to share our findings because a rash from Zika is not particularly identifiable,” said Chen, one of four UM/Jackson doctors who conducted the study. “This puts an image in people’s minds.”
As of Thursday, there were 1,302 Zika cases in Florida, according to the Florida Department of Health‘s latest figures. Of those, 1,026 were travel-related cases, 257 were locally acquired cases, and another 19 were undetermined. Pregnant women with lab evidence of Zika accounted for 210 of the total cases. (The state does not say whether the cases involving pregnant women stem from travel or from local mosquitoes.)
Of the 257 locally acquired cases, 244 originated in Miami-Dade. Miami-Dade has been the epicenter of locally acquired Zika cases, with state and federal health officials confirming in July that a section of Wynwood contained the nation’s first cluster of Zika cases spread by local mosquitoes.
The virus then spread to Miami Beach, where the Zika zone stretched from Eighth Street to 63rd Street in September. By December, state health officials said mosquitoes were no longer spreading Zika in South Beach, the last of the Zika zones.
As of Jan. 4, there were 4,835 Zika cases in the U.S., according to the Centers for Disease Control and Prevention.
The Zika virus, first discovered in 1947 and named after the Zika Forest in Uganda, can be transmitted through mosquito bites, sex or blood transfusions. The Aedes aegypti mosquito transmits the virus. Many people infected won’t have symptoms or have very mild symptoms. Those who do later develop a fever, rash, joint pain, conjunctivitis, muscle pain and headache. This can last for several days to a week.
People very rarely die of Zika, and once infected, a person is likely to be protected from future infections.