The Centers for Disease Control and Prevention (CDC) has confirmed the first Zika-virus-related death in the United States, raising new concerns about the severity of the mosquito-borne disease and prompting renewed calls for Congress to approve the Obama administration’s two-month-old request for emergency funding to fight the ongoing outbreak.
According to a report released Thursday by the CDC, health officials have determined that the death of a Puerto Rican man in late February was caused by a rare immune reaction to the Zika virus. The patient, a man in his 70s, died from internal bleeding “related to severe immune thrombocytopenic purpura (ITP)”, a disorder in which the immune system attacks the platelets that control bleeding by helping blood to clot. This is the first time that Zika has been linked to a fatality in the United States or any of its territories, the CDC said.
“Although Zika virus–associated deaths are rare, the first identified death in Puerto Rico highlights the possibility of severe cases, as well as the need for continued outreach to raise health care providers’ awareness of complications that might lead to severe disease or death,” the CDC stated in its report.
Research so far has shown Zika itself to be a relatively mild and short-term disease in most cases, but secondary infections and transmissions have been linked to deaths and birth defects. The deaths of three people infected with Zika earlier this year in Colombia been tentatively linked to Guillain-Barré syndrome, a neurological disorder that – in rare cases – appears to be triggered by Zika virus. And in early April, the CDC confirmed Zika’s connection to microcephaly, a birth defect characterized by an abnormally small head and a spectrum of developmental problems.
Zika first began spreading in Puerto Rico in November. Of the 683 confirmed cases in the country since then, only one fatality has been noted, the CDC report said. Rash is the most common symptom among these patients, followed by muscle pain and headache. Sixty-five of these cases — 10 percent — have involved pregnant women. Puerto Rico has confirmed five cases of Guillain-Barré syndrome, but there are no reported cases of microcephaly so far, although one has occurred in the mainland US.
In the U.S., the first report of the Zika virus came out in Dallas in February. Interestingly, it was transmitted to the patient via sexual contact and not through a mosquito bite. Since then, 426 travelers have been diagnosed with Zika in the continental U.S., but the virus is not yet spreading among mosquitoes here, and there have not been any locally-acquired cases, according to the CDC.
However, mosquito season is stirring in the southern U.S., and the virus has emerged in a new carrier across the border. Epidemiologists have uncovered evidence that the disease is present in tiger mosquitoes (Aedes albopictus) in Mexico, according an April 21 update from the Pan American Health Organization. This is the first reported occurrence of Zika virus found in wild tiger mosquitoes in the Western Hemisphere, according to the PAHO. And in March, scientists at the Oswaldo Cruz Foundation in Recife, Brazil, reported that they were able to infect another species of mosquito, Culex quinquefasciatus, with the virus. Working in a laboratory setting, the Brazilian team found that the virus was able to circulate to the salivary glands of the mosquitoes, suggesting that they could possibly transmit the virus by biting a person. If evidence confirms that it can spread the virus, the implications could be quite serious: the Culex quinquefasciatus mosquito is about 20 times more common than the Aedes aegypti mosquito, the species currently known to carry Zika.
Aedes aegypti mosquitoes are a tropical breed, so their geographic spread in the U.S. is mostly limited to Florida and southern Texas. In contrast, tiger mosquitoes extend as far as southern Minnesota, Ohio and New Jersey east of the Rocky Mountains and Northern California in the West.
“I think some states and local governments have been focusing on aegypti and less on albopictus, but this finding makes clear that both will require control measures,” Director of the University of Pittsburgh Medical Center’s Center for Health Security Thomas Inglesby told The Washington Post.
Despite these looming threats, Congress broke session on Friday, for a weeklong recess, still without addressing President Obama’s February request for emergency funding to fight the Zika virus. Congressional Republicans have delayed acting on the request, leaving public health officials scrambling to come up with the funds to address this growing problem.
The White House has allocated $589 million, collected from funds originally meant for the 2014 Ebola crisis, to combat and prepare for the Zika virus. However, this is only meant as a temporary measure and health officials say they are “distressed that money is being taken away from Ebola efforts, an important need in its own right, and that Congress is not providing more to fight Zika,” according to The Hill.
“We shouldn’t be taking 10 days off as a dangerous virus threatens this nation,” Senate Minority Leader Harry Reid said Thursday, the Atlantic reports. “And it is threatening us.”