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Scientists Just Documented First Case of Zika Spread Through Physical Contact

Health + Wellness

A mysterious Zika case in Utah has been solved and it shows we still don't know everything about the virus.

Back in July, a 38-year-old man stumped experts when he was diagnosed with the Zika virus, even though he hadn't traveled to any Zika-infected areas or had sexual contact with someone who did. He also lived in Salt Lake City, an area not considered a hospitable environment for the Aedes Aegypti mosquito that transmits the virus.

So far, the only ways Zika is known to be transmitted is through a bite from an infected mosquito, sexual contact with an infected person, contact with infected blood or a pregnant mother to her baby.

After tracking how this man could have gotten the virus, they discovered that he had visited a 78-year-old friend in a Utah hospital, just seven to 10 days before his symptoms began.

Eight days before the elderly man was admitted to the hospital, he had returned from a 3-week trip to the southwest coast of Mexico where it was learned he contracted Zika from mosquitoes, according to a new paper published in the New England Journal of Medicine.

During the 38-year-old's visit, the paper says he helped the nurse re-position his friend and had wiped the man's eyes. That's it.

The paper concludes:

"Given the very high level of viremia in Patient 1, infectious levels of virus may have been present in sweat or tears, both of which Patient 2 contacted without gloves. Transmission of the infection through a mosquito bite appears to be unlikely, since aedes species that are known to transmit ZIKV have not been detected in the Salt Lake City area. In addition, the second case occurred 7 to 10 days after contact with the index patient in the hospital, which implicates direct contact during hospitalization."

So can Zika be transmitted through someone's sweat or tears, and how easily?

In a study published on Sept. 6, traces of the virus were detected in the tears of mice, but there hasn't been any studies conducted yet on sweat.

"It should not be able to pass through unbroken skin," Sankar Swaminathan, the chief of infections disease at University of Utah Health Care, and first author on the paper, told The Atlantic. Meaning the man probably either had a cut somewhere on his skin, or he inadvertently touched his eyes, nose or mouth, and the virus entered his body.

What scientists are now looking into with this case is the severity of the elderly man's infection. Four days after he was admitted into the hospital he died and, while he was elderly, was reportedly not immunocompromised.

His blood had 200 million copies of the virus per milliliter—with a typical infection you'd expect to see hundreds of thousands, and 1 million would be considered high, Swaminathan said, which lead to progressive respiratory and renal failure, metabolic acidosis and hepatitis just before his death.

A factor being considered is that because he had contracted dengue in his past, it's possible remaining antibodies from that somehow worsened his infection. He also may have had a genetic immune deficiency that just happened to be very specific to this virus, and the fact that he had a very high viral load of the virus in his system is what likely led to it being transmitted in this way, Swaminathan said.

There have been 13 fatal cases in adults—not counting deaths from Zika-related Guillain-Barré—many of which had pre-existing conditions. While this case is definitely scary, mosquitoes and sexual transmission are still the main worries in the spread of the virus.

"For the general public, this doesn't really change very much," Swaminathan said.

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By Genevieve Belmaker

Last week, the Peruvian Palm Oil Producers' Association (JUNPALMA) promised to enter into an agreement for sustainable and deforestation-free palm oil production. The promise was secured by the U.S. based National Wildlife Federation (NWF) in collaboration with the local government, growers and the independent conservation organization Sociedad Peruana de Ecodesarrollo.

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The rallying cry to build it again and to build it better than before is inspiring after a natural disaster, but it may not be the best course of action, according to new research published in the journal Science.

"Faced with global warming, rising sea levels, and the climate-related extremes they intensify, the question is no longer whether some communities will retreat—moving people and assets out of harm's way—but why, where, when, and how they will retreat," the study begins.

The researchers suggest that it is time to rethink retreat, which is often seen as a last resort and a sign of weakness. Instead, it should be seen as the smart option and an opportunity to build new communities.

"We propose a reconceptualization of retreat as a suite of adaptation options that are both strategic and managed," the paper states. "Strategy integrates retreat into long-term development goals and identifies why retreat should occur and, in doing so, influences where and when."

The billions of dollars spent to rebuild the Jersey Shore and to create dunes to protect from future storms after Superstorm Sandy in 2012 may be a waste if sea level rise inundates the entire coastline.

"There's a definite rhetoric of, 'We're going to build it back better. We're going to win. We're going to beat this. Something technological is going to come and it's going to save us,'" said A.R. Siders, an assistant professor with the disaster research center at the University of Delaware and lead author of the paper, to the New York Times. "It's like, let's step back and think for a minute. You're in a fight with the ocean. You're fighting to hold the ocean in place. Maybe that's not the battle we want to pick."

Rethinking retreat could make it a strategic, efficient, and equitable way to adapt to the climate crisis, the study says.

Dr. Siders pointed out that it has happened before. She noted that in the 1970s, the small town of Soldiers Grove, Wisconsin moved itself out of the flood plain after one too many floods. The community found and reoriented the business district to take advantage of highway traffic and powered it entirely with solar energy, as the New York Times reported.

That's an important lesson now that rising sea levels pose a catastrophic risk around the world. Nearly 75 percent of the world's cities are along shorelines. In the U.S. alone coastline communities make up nearly 40 percent of the population— more than 123 million people, which is why Siders and her research team are so forthright about the urgency and the complexities of their findings, according to Harvard Magazine.

Some of those complexities include, coordinating moves across city, state or even international lines; cultural and social considerations like the importance of burial grounds or ancestral lands; reparations for losses or damage to historic practices; long-term social and psychological consequences; financial incentives that often contradict environmental imperatives; and the critical importance of managing retreat in a way that protects vulnerable and poor populations and that doesn't exacerbate past injustices, as Harvard Magazine reported.

If communities could practice strategic retreats, the study says, doing so would not only reduce the need for people to choose among bad options, but also improve their circumstances.

"It's a lot to think about," said Siders to Harvard Magazine. "And there are going to be hard choices. It will hurt—I mean, we have to get from here to some new future state, and that transition is going to be hard.…But the longer we put off making these decisions, the worse it will get, and the harder the decisions will become."

To help the transition, the paper recommends improved access to climate-hazard maps so communities can make informed choices about risk. And, the maps need to be improved and updated regularly, the paper said as the New York Times reported.


"It's not that everywhere should retreat," said Dr. Siders to the New York Times. "It's that retreat should be an option. It should be a real viable option on the table that some places will need to use."

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