Health Care

Zika count, and frustration, rise in Miami-Dade

Fighting Zika on the streets

As Miami-Dade mosquito inspectors continue to spray the Zika infested areas of Wynwood, Miami Police also lent a hand on Tuesday, passing out mosquito spray to homeless people in the area.
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As Miami-Dade mosquito inspectors continue to spray the Zika infested areas of Wynwood, Miami Police also lent a hand on Tuesday, passing out mosquito spray to homeless people in the area.

The Zika toll, and frustration, rose another notch in Miami-Dade County with the latest local case confirmed by state health officials on Wednesday.

The new case brings the total number of local cases in South Florida to 22. State health officials also reported 14 new travel-related cases, for a total of 439 across the state including the first cases in Bay County.

Health officials do not provide details about patients but said the latest Miami-Dade case is in the same area as previous infections. They remain convinced that active Zika transmissions are occurring only in a one-square-mile area of Miami near the Wynwood arts district and Midtown Miami.

As the number of local cases has surged, so have complaints from a public increasingly tense over global media coverage and the trickle of information from federal, state and local officials. In a standing-room-only meeting in Wynwood with state health officials, business owners and residents complained that too few details had ignited panic even as officials continue to refer people to the state’s hotline: 1-855-622-6735.

Meanwhile, one Zika-infected patient, a Miami Beach resident who agreed to speak to the Miami Herald only if his name was withheld, said with so little information available about where to get tested, he turned to Google to find the name of a local doctor who could provide it.

“I’ll be happy when the [the Centers for Disease Control and Prevention], the state and the locals can get on the same sheet of music about what they put out,” the patient said.

The circumstances of the 35-year-old patient offer a glimpse into how health officials are handling the cases, which are not public by law. It’s unclear whether his case has been counted in official numbers reported Wednesday. He lives in Miami Beach, works at home and has not traveled to Wynwood in at least six months. He suspects he got the virus from his wife, who travels throughout the county for work but has not shown any symptoms. She has not yet been tested. The couple last traveled abroad in March or April, to a region with no cases.

The patient said he started feeling achy and had sore eyes on Aug. 1 while out of town in an area with fewer than seven travel-related Zika cases and no local transmissions, making it unlikely he picked up the virus there. He returned home thinking he had the flu, then woke up Aug. 4 with a rash and decided to be tested, fearing that he might spread the virus to neighbors and friends.

“I thought the most responsible thing was to get tested to limit the ability to spread it,” he said.

But he wasn’t sure where. He looked online for a doctor doing Zika testing, found an urgent care center and made an appointment. The office sent him to a Coral Gables lab for testing. This week, on Tuesday, the office called to confirm the results and on Wednesday, just before 5 p.m., a state health worker called to question him, he said. Throughout, he said he never had any sense that any health officials were alarmed. When he raised concerns about being bitten by mosquitoes that might infect others, he said the health workers seemed unconcerned.

“Honestly, throughout this whole process I’ve never felt a sense of urgency or panic from anyone involved,” he said in a text. “Maybe that’s by training/design, or maybe it’s just Miami.”

That perception has also annoyed business owners in the Wynwood neighborhood who say government officials are not providing enough accurate, up-to-date information. On Wednesday, the state health department sent Isabel Griffin, a 25-year-old epidemiologist who is investigating the Wynwood outbreak, to the meeting. County mosquito control manager Chalmers Vasquez and senior division director Lee Casey also attended, but refused to answer questions afterward.

Since the outbreak, the county has increased efforts to tamp down the Aedes aegypti mosquito that carries the virus, bringing on about 128 additional inspectors to help out a full-time staff of 12. On Wednesday, a low-flying plane misted the area with a nontoxic larvicide intended to kill mosquito eggs, Casey said. But a flight that was scheduled to fly at 6:30 a.m. was still flying overhead at 10 a.m., angering business owners already on edge about scaring away customers.

“For you to fly over Wynwood at 10 a.m. is irresponsible,” Wynwood Business Improvement District board chair Joe Furst told Casey.

During the packed meeting, business owners and residents complained that health officials and mosquito inspectors had not contacted them and had too little presence in the neighborhood.

“Our politicians should be here every day to show us the situation is under control,” said board member David Polinsky.

They also complained that while health officials believe active transmission is limited to a small area with a 500-foot radius from the initial cluster, the warning zone is five times larger, encompassing a one-square mile area.

“Why can’t you tell us the exact location of where this happened?” asked Robert De Los Rios, co-founder of WynwoodMap.com. “It’s affecting all of us.”

Since the beginning of August, federal health officials have warned pregnant women to steer clear of the area, the first such warning issued in the nation. The virus, which raced across Latin America and the Caribbean, is linked to birth defects in babies, including microcephaly, that has caused alarm among expectant mothers and women trying to become pregnant. The virus, Griffin said, is “entirely preventable” with simple steps like using repellent and emptying containers where mosquitoes breed. Once they’ve had the illness, patients will have antibodies that will prevent them from getting sick again, she said.

“Eventually, the number of infected people in this area will decline. Think about it like a vaccine. Diseases spread as long as there are susceptible people,” she said. “Eventually, the virus will run out of hosts.”

Vasquez, of the county’s mosquito control unit, also said that while initial spraying had reduced mosquitoes, the number had started to rise again with recent heavy rain. The county plans to conduct eight aerial treatments altogether, four with an insecticide called Naled and four with BTI, an organic larvicide to attack eggs. The area has been divided into sectors, with nine teams doing door-to-door inspections in search of breeding mosquitoes, he said. Even with those efforts, Casey said business owners and residents need to do their part.

“You represent a lot of our boots on the ground,” he said. “It’s incredible to expect we would have enough people to inspect every house.”

In addition to the local case, health official also reported seven additional travel-related cases in Miami-Dade Wednesday. Other travel cases around the state include two in Bay County, two in Palm Beach County, and one each in Lake, Seminole and St. Lucie counties.

Zika cases in Florida by county since Aug. 10

County

Number of Cases (all travel related)

Alachua

5

Bay

2

Brevard

10

Broward**

56

Charlotte

1

Citrus

2

Clay

3

Collier

4

Duval

6

Escambia

2

Hernando

2

Highlands

1

Hillsborough

12

Lake

2

Lee

7

Leon

1

Manatee

2

Martin

1

Miami-Dade**

117

Monroe

1

Okaloosa

2

Okeechobee

1

Orange

48

Osceola

18

Palm Beach**

22

Pasco

6

Pinellas

7

Polk

13

Santa Rosa

1

Seminole

16

St. Johns

3

St. Lucie

4

Volusia

5

Total cases not involving pregnant women

383

. . .

. . .

Cases involving pregnant women regardless of symptoms

57

* Counties of pregnant women not disclosed.

** Does not included suspected cases of local transmission.

Source: Florida Department of Health

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