Zika Infection Spread By Sex In Dallas – Earlier Sexual Transmission In Colorado – Detailed Symptoms

Zika Infection Spread By Sex In Dallas – Earlier Sexual Transmission In Colorado – Detailed Symptoms News came out of Dallas yesterday of a case of the Zika virus being spread by sexual intercourse. This is however not the first US example of this virus, linked to brain deformities in children, being passed on to a partner through sex. An earlier case in Colorado made history as the first example of sexual transmission of an insect borne virus (arbovirus).

Kobylinski, Foy, collecting mosquitoes in Senegal with Massamba Sylla (courtesy of Brian Foy)

Kobylinski (left) and Foy (right) prior to showing symptoms of Zika, collecting mosquitoes in Senegal with Massamba Sylla (courtesy of Brian Foy)

Yesterday the US CDC (Centres For Disease Control and Prevention) rapidly issued recommendations urging the use of condoms to prevent the spread of the Zika virus through sexual intercourse. This followed a report from the Dallas Health Authorities who had been tracking the case of a person having returned from Venezuela a couple of weeks ago. They believe the person was infected with Zika by a mosquito while staying in Venezuela. Following their return to Dallas the person had sex with a second person who soon started to show ‘flu like’ symptoms.

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This second person, who had not been outside of the Dallas area, went to their doctor who decided to have blood samples checked for possible causes. After two weeks of testing the CDC were able to rule out other possible viruses, including dengue and chikungunya. They confirmed however that Zika was present in samples from both individuals. Mosquito testing around the couple’s home confirmed that there were no mosquitoes of the type that transmits Zika (Aedes). In addition there are very few mosquitos at this time of year in the vicinity of the residence.

Zika Transmitting Mosquito Aedes aegypti

Zika Transmitting Mosquito Aedes aegypti

As I reported in my article about Zika on January 19th 2016 (link below)….

19th Jan 2016 ZIKA – Which Countries to Avoid? – Where is Risk highest in USA? – Microcephaly link

….there have been earlier reports of sexual transmission of the Zika virus in the USA.

In this earlier case the victims were a professional biologist and his wife who wrote up their experiences in a scientific paper in May 2011. The biologist, Brian Foy of Colorado State University in Fort Collins, had been working in Senegal in 2008 at the same time that the (then) rather obscure Zika pathogen was also present. Upon his return home to Dallas he engaged in sexual intercourse with his wife Joy Chilson Foy. Joy Chilson Foy a local nurse, was also a co-author in the scientific paper published 3 years later, and had not left the USA since 2007 (and had never been to Africa or Asia where Zika was then known to be present).

Rash on Back of Joy Chilson Foy After Sex With Zika Infected Husband in 2008

Rash on Back of Joy Chilson Foy After Sex With Zika Infected Husband in 2008

Brian Foy was involved in a mosquito gathering project in Senegal and was bitten several times in his short stay by the Aedes mosquito which is the main vector of the Zika virus. He returned home to Northern Colorado on August 24th 2008. Within 5 days of his return he and a colleague developed symptoms typical of a Zika infection but not until after he had engaged in sex with his wife. The report describes that the ‘vaginal sexual intercourse’ took place before he had symptoms of the disease.

The symptoms Brian Foy exhibited from August 30th were a rash on his torso, extreme fatigue, headaches, and swollen and painful wrists, knees, and ankles. He did not have fever. He also had symptoms of prostatitis: painful urination and blood in his semen (called hematospermia – a red–brown fluid in the ejaculate that came out of his penis). His wife developed symptoms from September 3rd including malaise, chills, extreme headache, photophobia, and muscle pain that continued until September 6. She also did not have fever but developed a rash on her back from September 7th (see picture above).

Aphthous lip ulcer

Typical Aphthous lip ulcer on the inside of the mouth

In addition Brian Foy developed two aphthous ulcers on his lips on September 2nd and his wife developed a similar ulcer on the inside of her lip on September 7th. Both patients also exhibited joint pains and Joy Chilson Foy had conjunctivitis (see picture below) from September 8th. None of their four children exhibited any of the syptoms typical of a Zika infection during this period.

Aphthous ulcer 2 on lip

Typical Aphthous ulcer on the lip

One of the reasons it took until 2011 to publish the results of this sexual activity in 2008 was the uncertainty about the cause of the symptoms. It was a chance meeting of Foy’s PhD student Kevin Kobylinski (on the left in the picture above) with entomologist Andrew Haddow on another trip to Senegal that set the scientists on the scent of Zika. Haddow’s grandfather was one of the scientists that isolated the virus in the Zika forest of Uganda in 1947 and he pointed out that the symptoms described above were typical of this disease.

Kobylinski who had had similar symptoms to Foy when they both returned from Senegal explained Haddow’s suggestion to him and they sent the samples they had kept since September 2008 (in the freezer) to Haddow for testing. He was able to confirm the presence of Zika.

Eye with viral conjunctivitis

Eye with viral conjunctivitis

Although the evidence that Foy transmitted the virus to his wife through sex was not direct the circumstantial evidence was very strong. She was unlikely to have been infected by an aedes mosquito because they were not present on Northern Colorado. In addition it takes the virus two weeks to complete its life cycle in a mosquito before it can reinfect another human being. However Foy’s wife showed symptoms just 9 days after those of her husband..The fact ttat they had sex together is clearly documented in the 2011 research paper (the link to the original paper by is here – Foy BD, Kobylinski KC, Foy JLC, Blitvich BJ, Travassos da Rosa A, Haddow AD, et al. Probable non–vector-borne transmission of Zika virus, Colorado, USA. Emerg Infect Dis 2011 May; 17(5): 880–882).

Together with its growing link to microcephaly (reduced skull and brain size in newborns) I think we will be hearing a lot more about the risks of sex with people from Zika areas in the near future. Here is a current map of those area were Zika is present:

CDC's Zika World Map 15 Jan 2016

CDC’s Zika World Map 15 Jan 2016

This development shows how important it is to think outside of the box when trying to combat dangerous infectious disease epidemics. The story above details the first published example of an insect born arbovirus being transmitted between humans by sex. With this in mind you might also be interested in my article about the importance of identifying whether bed bugs could aso have a role in the transmission of arboviruses like Zika. Here‘s the link:

 Bed Bugs – Insecticide Resistance – Arbovirus Transmission – Zika and Microcephaly

One final comment – Yesterday the American Red Cross appealed to prospective donors who have visited Zika outbreak zones to wait at least 28 days before giving blood. It said risks of transmitting the virus through blood donations remained “extremely” low in the continental United States (info from Reuters).

Chris Duggleby

Caution Advised before having Sex With People From High Risk Zika Areas - Aedes mosquito distribution maps US

Caution Advised before having Sex With People From High Risk Zika Areas – Aedes mosquito distribution maps US

Chris Duggleby started his scientific career studying Bacteriology, Virology and Immunology at the Manchester University Medical School. From there he went on to spend over 35 in the chemicals and oil industries which included setting up a polymers research and development group in Geneva, Switzerland for a major international chemicals company. Following an MBA from Warwick University he went on to lead a number of international manufacturing and marketing operations in the Chemicals, Plastics and Oil industries. This included being the founding President of Formosa BP Chemicals Corporation in Asia. His work involved living and working in Europe, Asia, the USA, the Middle East, and Russia. More recently he was invited to take on a senior leadership position in the Audit Department of the BP International Oil Group. Here he used his global change and risk management experience to help the group reshape its management structures and processes following a major environmental disaster in the Gulf of Mexico. He has now retired to focus on writing about risk management and producing music in his studios near London, in the Alps and Cape Town. If you are interested in risk management check out his RiskTuition.com or BizChangers.com (management of change) sites. He has also recently launched the JointVentureRisk.com site.

If you found this article interesting please consider taking a look at some of his other recent reports on similar subjects.

Just click on the titles below:

…starting with some more serious stuff…

1st Feb 2016 Sexual Competition Between Women – Ovulation Can Be Seen In The Face

31st Jan 2016  Bed Bugs – Insecticide Resistance – Arbovirus Transmission – Zika and Microceph

19th Jan 2016 ZIKA Virus Epidemic  – Health Warning – Pregnant women should postpone travel to affected areas – Including Brazil 

17th Jan 2016 Bubonic Plague Special – Lice – Hosts for The Black Death Bug

13th Jan 2016 Kill Head Lice In A Day With The Newly Developed Plasma Nitcomb From The German Fraunhofer Institute

8th Jan 2016 Cancer from Handbags, Shoes and Gloves – Allergic Reactions to Jewellery – German Institute Identifies Excessive Chromium 6 and Nickel Levels

13th December 2015 Health Risk – Potential Carcinogens Found in Advent Calendar Chocolates – German Investigation

26th July 2015 Poison in your Washing Machine: Allergic Contact Dermatitis from Laundry Detergents, Softeners, Conditioners and Whiteners

25th October 2015: Health Risks: Food allergy prevention – Latest research ‘feed infants early with allergenic food

17th October 2015: Health Risk: Vitamin and antioxidant supplements help cancer cells become malignant – latest research from Texas

31st May 2015: German Concern about Potentially Carcinogenic Aromatic Hydrocarbons in Cosmetics  

11th May 2014: Product Development Risk: New Air Conditioning Coolant Gas Produces Carbonyl Difluoride (Highly Toxic – Related to WW1 Gas Phosgene) in Vehicle Fires

16th April 2014: Ethical Pricing: Same Drug – For Leukaemia 21 Euro (Now Withdrawn) – For Multiple Sclerosis 888 Euro

6th April 2014: Product Quality Risk: Shoes Sold On-line By Zalando Recalled Due To Chromium 6 Contamination – Known Allergen And Carcinogen

29th December 2012: Spreading diarrhea and vomit through the washing machine– The Norovirus propagator in our kitchen

and here are some fun reports…

21st June 2015: Bio-undies: Guilt free Passion with ‘Easy Emma’ and ‘Loose Harry’and Getting Rid of Garden Snails with Rent-a-Duck

4th March 2015: Hamburg Reeperbahn (St. Pauli): Germans install walls that urinate on passers-by

19th April 2014: German Police Catch Hedgehogs Testing Home Made Crash Helmets in Saarbrücken

17th April 2014: Niche On-line Dating Services (Specialities: Herpes, Thrush and Genital Warts)

18th March 2014: Germany and Finland Joint Investigation: New Case of Sexual Cannibalism Including Self-mutilation (Castration) During Intercourse.

18th August 2012: How Bavarians and Austrians use their middle finger – Fingerhakeln: a men-only sport (did Arnold Schwarzenegger start training this way?).

You can also find some of my more humorous reports in the Alpine Press section of this site using the link here.

Now prepare yourself for an uplifting experience! 

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