Public Health

Zika Virus Comes to Ohio by Way of Haiti

State health officials said a 30-year-old Cuyahoga County woman and a 21-year-old Stark County man have the first confirmed cases of Zika in Ohio.

by Amanda Garrett, Akron Beacon Journal / February 10, 2016

(TNS) - Two Northeast Ohio residents who visited Haiti on unrelated trips brought home the same unwanted souvenir in January: Zika virus.

State health officials Tuesday said a 30-year-old Cuyahoga County woman and a 21-year-old Stark County man have the first confirmed cases of Zika in Ohio. They did not disclose the names of the woman or man, but said their contraction of Zika is not related.

The woman’s symptoms appeared at the end of January, the man’s occurred earlier in that month, officials said.

Despite two cases reported on one day, local health officials said Tuesday the risk of contracting Zika — which is spread by some mosquitoes and through sexual intercourse with someone carrying Zika — is very low for most Ohioans who never venture to warm climates where Zika virus thrives.

But they urged pregnant women and women who plan to become pregnant to closely follow the news about Zika because scientists are in the early stages of understanding the virus, its transmission and its impact on health.

About 80 percent of people who contract Zika have no symptoms, which can include a fever, rash and joint pain, said Dr. Richard Watkins, an infectious disease physician with Cleveland Clinic Akron General. Yet Zika could be doing irreparable harm in pregnant women.

Effect on pregnancies

Zika is suspected of causing microcephaly — a birth defect that causes abnormally small heads and small, sometimes damaged, brains.

Zika was first confirmed in Brazil in May. Since October, doctors in that South American country have reported more than 4,000 suspected cases of microcephaly, compared to 147 cases in all of 2014.

Researchers haven’t yet figured out if Zika, Zika in combination with other factors or something else entirely has caused the wave of microcephaly.

But the U.S. Centers for Disease Control and Prevention — which has sent teams of doctors and scientists to Brazil — isn’t waiting for a conclusive answer. Last month it issued a travel advisory for pregnant women and those trying to get pregnant, urging them all to avoid travel to an ever-expanding list of countries where Zika has been detected.

So far, that advisory doesn’t include areas in the United States. But the same type of mosquitoes that carry Zika in Brazil and elsewhere also exist in Florida, Texas and parts of the U.S. South.

Dr. Mary DiOrio, medical director for the Ohio Health Department, said public health officials in those states are ramping up mosquito eradication efforts. In Ohio, officials are gearing up, too.

A cousin of the mosquito that carries Zika lives here, she said. In March, the Ohio Health Department will begin meeting with healthcare providers, public health and emergency management officials about what to do if there is a Zika outbreak here when the weather turns warm and mosquitoes return.

Zika is so new to state health officials, no one in Ohio can test for it yet, DiOrio said. A lab at the CDC in Atlanta tested the blood of the Ohio woman and man who have the virus. Officials here shipped blood samples to the lab, DiOrio said.

Ohio officials hope to have what they need from the CDC to run their own tests in a couple of weeks.

Although Zika is a trending topic on Twitter and other online social media, only a few patients have asked Dr. Stephen Crane, head of Akron Children’s Hospital Maternal Fetal Medicine department, about the virus, he said Tuesday. But Crane said he’s starting to bring it up.

The CDC has found Zika virus in semen, saliva and urine.

A few days ago, the CDC urged men who travel to Zika-impacted areas to abstain from sex or to wear condoms during intercourse with pregnant partners for the duration of the pregnancy. The agency issued the guidance after a Texas man, who had traveled to Venezuela, sexually transmitted the virus to someone who had not left the U.S.

The CDC has not issued warnings involving saliva or urine, although Brazil’s health authorities have advised pregnant women to avoid kissing.

Vaccine coming?

Crane, who chairs maternal fetal medicine at the hospital, said this isn’t the first virus suspected of causing birth defects.

Rubella — sometimes called German measles or three-day measles — can cause blindness, deafness and mental retardation in children whose mothers get sick during pregnancy, he said.

Between 1962 and 1965, there was a worldwide rubella epidemic, including about 12.5 million cases in the U.S. that resulted in 11,250 fetal deaths, 2,100 neonatal deaths and about 20,000 infants born with several birth defects, according to the CDC.

A rubella vaccine was approved in 1969. There were only nine cases of rubella reported in the U.S. in 2004 (the most recent year on the CDC’s website) about half of which occurred in people who were born in another country.

“Hopefully, there will be a vaccine for Zika, too, but if you’re dealing with underserved third-world countries, they might not have the resources,” Crane said.

U.S. Sen. Sherrod Brown (D-Ohio) and two other lawmakers Tuesday introduced a bipartisan bill in Congress to accelerate the development of a vaccine and treatments for Zika.

The legislation would add Zika to a U.S. Food and Drug Administration program that encourages the development of treatments for tropical diseases that don’t get much funding.

Dr. Marguerite Erme, medical director of the Summit County Public Health, said she hopes that Zika may raise awareness about other health risks to travelers.

“Mosquitoes have transmitted diseases for millennium,” Erme said. “A lot of times, we get complacent when we travel because we’re used to being in a country where all sorts of public health measures are in place.”

But travelers should read up on where they’re going and what they need to do to protect themselves.

For Zika and other mosquito-transmitted illnesses, that involves consistently covering arms and legs, using repellent and avoiding being outdoors at sunset, when the bugs are most active.

Based on information available now, Zika shouldn’t disrupt travel for anyone except pregnant women or those trying to get pregnant, she said.

“Zika is something for people to pay attention to, like any emerging issue,” she said. “Learn, take precautions, but don’t get paranoid.”


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