Following the recent Zika transmission outbreak in Miami-Dade County, a multidisciplinary team of physicians with the University of Miami Health System and Miller School of Medicine published a case study today in The New England Journal of Medicine, describing in detail the nation’s first locally-spread case of Zika transmission
The findings of the case study, titled “Cutaneous Eruption in a U.S. Woman with Locally Learnt Zika Virus Infection,” largely center on the skin rash associated with the then-23-year-old pregnant patient’s diagnosis and deliver a glimpse of the skin manifestations of the Zika virus. The report may have implications for future Zika transmission screening, diagnoses and linkage to care throughout the United States and abroad.
“Dermatologists and clinicians had an idea of what the Zika rash looked like, but it wasn’t until the patient obtainable here that we were able to get an up-close and personal look and photograph the skin,” said Lucy Chen, M.D., a Jackson Health System dermatology resident and lead author of the case study. “Any doctor now has a visual sense of the rash to properly identify and refer patients to the appropriate specialists.”
The young woman whose case is detailed in the report was 23-weeks pregnant in July 2016 and had knowledgeable three days of low-grade fever, a extensive rash and sore throat. The rash consisted of small pink bumps on the patient’s chest, back of her arms, legs, palms and soles, said Chen, who saw the patient upon admission. Her indications later advanced to muscle and joint pain. The patient tested positive for Zika although neither she nor her partner had traveled outside of the U.S. The case was confirmed by the Miami-Dade County Department of Health as the first non-travel-related case of Zika in the U.S.
The virus was current in her system for two weeks in urine samples and six weeks in blood samples. Tests, thus far, on the patient’s baby show normal development, head size and intracranial anatomy, with no calcifications. The infant, who was born in October 2016, did not test positive for Zika.
Zika virus, a mosquito-borne virus, is conveyed by the Aedes Aegypti mosquito. As Miami-Dade County has the highest number of locally-transmitted and travel-related Zika cases in the U.S., University of Miami physicians at Jackson Memorial Hospital are uniquely located to document cases of Zika in adults and children and contribute to the growing knowledge of the virus, which has heavily impacted countries through Latin American, the Caribbean and parts of the U.S.
Christine Curry, M.D., Ph.D., who leads the care of Zika-infected pregnant women at the University of Miami and Jackson Health Systems, said the patient is “an example of how the virus can mingle in the body of a pregnant