Mystery surrounds the first Zika virus-related death in the continental United States. The 73 year-old patient, who died in June, transferred the virus to a visitor who hadn’t done anything to put him at risk … so it was thought.
Researchers from the University of Utah School of Medicine and ARUP Laboratories in Salt Lake City investigated this unusual case and found interesting results. The patients had traveled to southwest Mexico, an area known for a Zika outbreak. Eight days after returning home, he exhibited symptoms like abdominal pain and eye swelling and tearing that landed him in the University of Utah hospital. His symptoms grew worse as his blood pressure dropped and his heartbeat quickened.
During his hospital stay he had a visitor. The only contact he had with the patient was through wiping away the patient’s tears and repositioning him in the bed. Sadly, the patient died after he went into septic shock and suffered organ failure. Few adults die of the virus, so the patient’s death was perplexing.
The visitor was surprised to fall ill seven days later, only to be diagnosed with Zika, after exhibiting the tell-tale symptoms. The researchers were intrigued and wanted to find out the mysterious cause of transmission.
This case expands our appreciation for how Zika can potentially spread from an infected patient to a non-infected patient without sexual contact or a mosquito vector. This and any future cases will force the medical community to critically re-evaluate established triage processes for determining which patients receive Zika testing, and which do not.
In studying the case, the first patient ‘s blood had an unusually high concentration , 200 million particles per milliliter of the virus. It was more than enough to overwhelm the patient’s system and made him highly infectious. Thus, his tears and sweat may have contained a higher concentration of the virus and made him contagious.
Sanker Swaminathan, MD, Chief of Internal Medicine at the University of Utah School of Medicine and corresponding author of the study states,
I couldn’t believe it. The viral load was 100,000 times higher than what had been reported in other Zika cases, and was an unusually high amount for any infection.
This rare case is helping us to understand the full spectrum of the disease, and the precautions we may need to take to avoid passing the virus from one person to another in specific situations. This type of information could help us improve treatments for Zika as the virus continues to spread across the world and within our country.
The mystery still remains as to why this particular patient had such a large concentration of the virus. He had been bitten by mosquitoes multiple times and, perhaps, his biology caused issues.
Swaminathan sums up,
We may never see another case like this one. But one thing this case shows us is that we still have a lot to learn about Zika.