CDC's Frieden: Florida Zika Cases Were Expected

Local Zika transmission in Florida appears to be associated with a trendy neighborhood in North Miami but there's no immediate need to urge people to stay away, according to CDC Director Tom Frieden, MD.

The four cases reported in Florida appear to have no other risk factor for Zika than an association with the Wynwood Arts District, Frieden told reporters in a telebriefing.

What would help pin down the apparent local transmission is finding infected mosquitoes in the area, he said, but that hasn't happened yet.

In the meantime, Frieden said, it remains unlikely that Florida will see a widespread outbreak that would increase the need for a travel advisory like those the CDC has issued for many countries in Latin American and the Caribbean, including Puerto Rico.

But, he added, "we will reassess that every single day."

The four patients were probably infected in the neighborhood early in July, became sick a week later, and were diagnosed a couple of days after that, Frieden said. The Florida health department immediately began an epidemiological investigation, which suggested the association with the Wynwood area.

One of the patients lives in nearby Broward county, but works in the Wynwood area.

Florida has begun door-to-door surveys to see if other cases can be found, he said, as well as conducting mosquito abatement measures in the Wynwood district.

He noted that Zika is a "very focal disease" -- it is spread by the Aedes aegypti mosquito, which travels only a few hundred feet during its entire lifetime, so that local abatement measures can have an important effect.

Experts have been predicting that some local transmission would occur in the parts of the southern U.S. where A. aegypti lives, so the Florida cases were "not unexpected," Frieden said.

He added that the timing was also expected -- it coincides with an upsurge in mosquitoes and it is roughly the same time of year that previous outbreaks of dengue fever have been seen.

Frieden also pointed out 89% of people infected by the virus have no symptoms, so finding cases in Miami doesn't mean residents or visitors are at greater risk than they would be elsewhere. It might just mean that cases elsewhere haven't been detected, he said.

But like dengue fever and chikungunya -- two related viruses also carried by A. aegypti -- it's likely that locally acquired cases in Florida will be "dead ends" and will not result in further transmission, Frieden said.

On the other hand, he repeated the CDC's advice to pregnant women -- use a DEET-based mosquito repellent, wear long sleeves and pants, and generally avoid mosquito bites.

Frieden's comments on the Florida cases came as the agency reported that some 5,582 people in Puerto Rico have been infected with the virus, including 672 pregnant women, from Nov. 1, 2015 to July 7, 2016.

In the July 29 issue of Morbidity and Mortality Weekly Report, investigators from the CDC and the Puerto Rico health department also reported that positive tests for people with suspected Zika rose from 14% in February to 64% in June.

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CDC's Frieden: Florida Zika Cases Were Expected