Jacksonville 904 — April/May/June 2017
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Health: Silent Swarm
Emily Goldman

Silent Swarm

The dangers of the Zika virus still lurk in South Florida and could return to our area soon

The Zika virus buzzed in and out of news outlets for much of last year, and for good reason. The Center for Disease Control (CDC) has yet to find a vaccine or cure for the virus, which can result in serious health problems.

The disease is spread primarily through mosquito bites. Every Floridian knows the dangers that rest in standing water, but few think of the many maladies contractible from a mosquito bite. Therefore, doctors warn Floridians and state visitors to be even more wary of things that fly and suck blood.

Making matters more difficult for Florida residents, mosquito populations tend to be larger the warmer and wetter it gets. Despite absence of much in the way of recent news coverage, the virus has not gone away, but rather lessened during the cooler winter months.

“There is a seasonal variation in the spread of this disease which coincides with the varying mosquito populations,” says Dr. Saima Aftab, Nicklaus Children's Hospital’s chief of fetal care center and chief of neonatal/ perinatal services, in Miami. “The risk for spread of Zika is highest in the summer months where the heat and abundant rainfall leads mosquito populations to grow. By winter the risk of mosquito transmitted illnesses such as Zika decreases significantly.”

With mulitple rivers, wetlands, an ocean and a proclivity for thunderstorms, Jacksonville is more than suitable as a mosquito breeding ground.

“Even the smallest amount of standing water could grow hundreds of mosquito eggs,” says Dr. Patrick Duff of the division of internal fetal medicine at the University of Florida’s department of OBGYN.

In June of last year, the first travel-related case of the Zika virus was reported in Duval County, resulting in its addition to the list of counties under a public health emergency. A “drain and cover” message (drain any standing water, cover doors and windows with screens) was the hold music for 630-CITY, Jacksonville’s public hotline for city-related matters, heard by more than 60,000 callers per week. Zika information was included with 360,000 JEA utility bills. Informational signage was placed on JTA buses and at highway rest stops.

By November 2016, more than 1,100 infections were reported in the state, though mosquitoes carrying the virus were only ever found in Miami’s Wynwood neighborhood and Miami Beach. Most infections in Northeast Florida were international travel-related. This year, a total of 31 cases of the virus have been reported in the state so far. While the Department of Health (DOH) in Duval reports no cases of Zika in 2017, the organization continues to take measures to protect the region against the disease.

“DOH-Duval continues to provide guidance, organize testing for pregnant women and investigate potential cases,” says Alison A. Hewitt, DOH public information specialist.

The DOH plans to develop various public information campaigns trying to reach high risk and vulnerable areas, going the extra step by offering information in various languages to ensure everyone understands the available information. The department is also working with healthcare professionals in the area, implementing an outreach program that monitors and addresses questions about Zika from the public.

Making the disease even more dangerous, mosquitoes infected with Zika are like “stealth bombers,” says Dr. Duff. “The mosquito that spreads this virus is an amazing little pest. It tends to hang out under leaves of foliage instead of on top, which makes it difficult to spray because of the canopy the leaves provide. Most mosquitoes tend to be out in the morning hours or dusk, but this one is out all of the time.”

Men and women can spread the virus through sexual contact and blood transfusions, while mothers can also pass along the disease to unborn children if infected while pregnant. According to the CDC, Zika infection during pregnancy can cause a birth defect of the brain called microcephaly and other severe fetal brain defects. Microcephaly causes severe deformity upon birth, along with other issues.

Zika presents a host of dangers to an unborn child, causing little to no symptoms to those infected.

“The real issue [with Zika] is the rare adult [for whom the virus causes] Guillain-Barre syndrome or the adult who gets pregnant and then it’s a different ball game,” says Duff. Guillain- Barre is a disorder in which the body’s immune system attacks the peripheral nervous system, and research has Shown that it is strongly associated with Zika. Only a small portion of those infected get the syndrome, however.

Despite doctors urging people to be careful and avoid travel to places where the disease is prevalent, Aftab cautions against overreaction.

“Zika spread in the U.S. has not reached epidemic proportions,” she says. “While people should not panic, they should get educated about this disease.” Aftab also urges anyone who could have been infected to practice safe sex so as not to unknowingly spread the disease to a partner.

“The interesting thing is that only 25 percent of people have obvious symptoms. 75-80 percent of people are actually asymptomatic,” Duff says. For those who do exhibit symptoms, the signs are a low grade fever, conjunctivitis, arthralgias, myalgias achiness in the muscles and a characteristic skin rash that looks something like the measles.

“There basically are three different types of tests to be done,” Duff says. “So for patients who are being seen fairly soon after exposure—mainly within the first week or two—the best test is the PCR test which basically detects certain proteins in the virus through both blood and urine. The virus disappears from the blood in five to seven days but stays in urine up to two weeks.”

The California Department of Public Health released an emergency warning on March 31, saying that two invasive species of mosquito, which are known to carry Zika, dengue and yellow fever, have been found in ten California counties. Hot zones for California Zika appear to be areas known for heavy tech sector immigration such as Silicon Valley and Silicon Beach. The two species are now common in Mexico, Central and South America, the Caribbean and Asia. So far the only documented cases of viral transmission from a mosquito to a human took place in South Florida and Brownsville, Texas last year.

The first human experimental Zika vaccine testing began in Houston earlier this spring, and is scheduled to begin in Miami and San Juan, Puerto Rico. Researchers at the National Institute of Allergy and Infectious Diseases, which developed the vaccine, are looking to have enrolled up to 2,000 volunteer test subjects across the country by June. Initial results will not be available until late 2017, and a vaccine is at least two years away.

Look Out Below!

Tree care can be one dangerous business

Earlier this month a tree-removal truck was upended, causing the 32-ton crane it was carrying to crash into two homes on Jacksonville’s Westside. Apparently the part of the tree that the company was trying to remove was too heavy for the crane. Thankfully no one was injured.

Few people realize the constant dangers that tree care industries present to its workers. It’s usually firefighters, members of the armed forces and police officers who generally earn the label of hero for their dangerous duties. “We’re probably the fourth or fifth as the most dangerous careers,” says Peter Gerstenberger, senior advisor to safety compliance for the Tree Care Industry Association (TCIA).

In 2016, TCIA reported 153 total tree care-related occupational incidents in the U.S., of which 92 were fatal. Within the industry there are three types of accident causations known as the Big Three— fall, struckby and electrical contact incidents. There were 26 fall fatalities in 2016, 26 struck-by fatalities, and 23 electric contact fatalities. “It’s safe, if you know how to do it,” says Gerstenberger. Tcia.org

The mosquito that spreads this virus is an amazing little pest. It tends to hang out under leaves of foliage instead of on top of the leaves which makes it difficult to spray because of the canopy of the leaves

DR. PATRICK DUFF, University of Florida