Zika Virus Infection Without Known Risk Factors

Summary and Comment |
September 14, 2016

Zika Virus Infection Without Known Risk Factors

  1. Stephen G. Baum, MD

A person in Utah contracted Zika virus apparently through nonsexual contact with a dying Zika-infected patient with a high viral load.

  1. Stephen G. Baum, MD

New information about the epidemiology and complications of Zika virus (ZV) infection is accruing rapidly. We now know that this infection can be transmitted by certain Aedes mosquitos as well as bidirectionally through sexual contact (both from male to female and female to male), even when the transmitting partner is asymptomatic.

Now, researchers report acquisition in Utah in July 2016 of ZV by Patient A, whose only risk factor was close contact with an elderly index patient (a family member) who had returned from a Zika-endemic area. Patient A had not traveled to an endemic area, did not have sexual intercourse with someone who had traveled, and did not receive blood transfusion, organ transplantation, or mosquito bites. Patient A hugged, kissed, and helped care for the index patient and held him while others disposed of the index patient's stool. The index patient developed septic shock and died in the hospital on June 25, 2016. A blood specimen taken from the index patient two days before death had a viremia level 100,000 times the average for patients with ZV infection.

Patient A developed fever, rash, and conjunctivitis six days after the index patient's death. On day 7 of Patient A's illness, his urine was positive for ZV by real-time reverse transcription-polymerase chain reaction, and four days later, after resolution of the illness, his serum was positive for immunoglobulin M and plaque neutralizing antibodies to ZV. All of 19 other family contacts of the index patient were negative for ZV symptoms and infection. Testing of neighbors and healthcare workers involved in the index patient's care has identified no ZV infection but is ongoing. No Aedes mosquitos were detected in the area.


Although this is a preliminary study, ZV appears to be transmissible by body fluids such as tears or saliva, especially when the viral load is exceptionally high. These findings should prompt increased precautions in caring for patients with ZV infection.

Editor Disclosures at Time of Publication

  • Disclosures for Stephen G. Baum, MD at time of publication Consultant / Advisory board Clinical Infectious Diseases (Editorial Advisory Board) Speaker’s bureau UpToDate (author) Editorial boards Medical Letter (Board of Directors, Chairman)


Reader Comments (1)

Gary Chandler, Ph.D Other Healthcare Professional, Neurology, Author

Solutions begin with the truth. Infectious mosquitoes are a symptom of mismanaged infectious waste. There are several steps that we can take to stop the spread of Zika virus and the broader threat of neurodegenerative disease.

1. Stop spreading misinformation. Neurodegenerative disease is infectious and millions of victims are producing tons of infectious waste every day (blood, saliva, mucus, urine, feces and tissue) that ends up in the sewage stream. Deadly and unstoppable contagions known as prions proceed to mutate and multiply.

2. Stop dumping infectious waste on land like it’s fertilizer. It's contaminating our food and water supplies. It’s feeding and infecting mosquitoes. The pathways to you and your family are numerous. Mosquitoes are just one.

3. Declare war on infectious waste, not just mosquitoes. It's time to enforce the Bioterrorism Preparedness and Response Act of 2002, which is there to protect our food, water and air from deadly agents, including nerve agents found in modern sewage streams.

It's time to reclassify sewage as infectious waste. Thanks to reckless policy and practices, we are using public funding to poison innocent citizens. Cities are dumping deadly dirty bombs on our crops and into our water supplies daily. Autism, microcephaly, Alzheimer’s, Parkinson’s, mad cow, chronic wasting disease and many more are symptoms of sewage mismanagement.

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