An elderly Puerto Rican man died from complications of the Zika virus earlier this year, the first reported death attributed to the disease in the United States
The victim, a man in his 70s, died in February from internal bleeding as a result of a rare immune reaction to an earlier Zika infection, according to the Centers for Disease Control and Prevention.
Puerto Rico now has 683 confirmed Zika infections in its outbreak, which began in December; 89 are in pregnant women, according to Dr. Ana Ríus, the territory’s health secretary. Fourteen of those women have given birth, and all their babies are healthy, she said.
Seventeen patients have been hospitalized for Zika-related causes in Puerto Rico. Of those, seven had Guillain-Barré syndrome, a rare form of paralysis that strikes about two weeks after an infection and, although frightening, is usually temporary.
The man who died was a resident of the San Juan area who fell ill with fever, rash and other typical Zika symptoms early this year, said Tyler M. Sharp, a C.D.C. epidemiologist working in Puerto Rico.
“That illness resolved,” Dr. Sharp said. “But very soon after, he had bleeding manifestations.”
He was hospitalized and died within 24 hours.
The condition that killed him, immune thrombocytopenic purpura, is similar to Guillain-Barré in that the Zika infection triggered his immune system to produce antibodies that attacked his own cells. In Guillain-Barré, they attack nerve cells, while in this case, they attacked the platelets, which cause the blood to clot.
The death was not described earlier because it took time to be sure Zika was the cause. “We had to check with family members, his personal physician and the doctors who managed him to be sure he didn’t have something else going on,” Dr. Sharp said.
Such deaths are rare but not unknown, he said. There have been three in Colombia
’s Zika outbreak. None that Dr. Sharp knew of were recorded in Brazil
, but the symptoms, he said, are easily misdiagnosed as dengue hemorrhagic fever, which is much more common.
Deaths from Zika are normally very rare in adults, and the illness is usually mild, with the rash lasting only a week. But the World Health Organization declared a global health emergency in February once it was suspected that Zika had caused a wave of microcephaly in Brazil. There are now almost 1,200 confirmed cases of microcephaly in Brazil, the agency said last week.
In the 50 United States, there have been 426 cases of Zika, all in returning travelers or, in a few cases, in sexual partners they passed it to. But the C.D.C. expects clusters of mosquito-transmitted cases in Florida
, the Gulf Coast and possibly Hawaii when the summer heats up.
The first commercial test for the Zika virus will become available to physicians as early as next week, which may speed diagnoses.
Quest Diagnostics, based in New Jersey, said on Thursday that the Food and Drug Administration issued an emergency use authorization to allow the test to be used as long as the health crisis continues.
At first, it will be available only at a laboratory in San Juan Capistrano, Calif.
, where it was developed. But the F.D.A. authorization could allow select labs throughout the United States, including Puerto Rico, to perform the test.
“It expands the possibilities of more patients around the country and Puerto Rico getting the testing that’s needed,” Dr. Rick L. Pesano, the company’s vice president for research and development, said in a phone interview on Friday.
Currently, to detect the virus quickly, a doctor must send blood taken during the first week of infection to the C.D.C. or a handful of other authorized laboratories. Two types of antibody tests for infections older than that are less accurate and can take weeks to perform
Dr. Pesano said Quest would also do tests at a second facility in Chantilly, Va.
, but its timetable was uncertain, and more of its laboratories could start doing it later.
This week, the United States Senate moved closer to approving $1.1 billion in emergency funds to fight the virus, but hard-line conservatives in the House are hesitant to approve new spending.