Florida officials are investigating three more cases of locally transmitted Zika — two of them outside the hotspot of Miami-Dade County. And Health & Human Services Secretary Sylvia Burwell is bug-spraying her family every day in the District of Columbia. Concern about Zika is clearly not slowing down.
Indeed, the volume of Zika testing nationwide rose by 33 percent last week, according to data from athenahealth's nationwide network.
After a slight leveling off the week before, the number of Zika tests ordered on athenahealth's network increased by about a third, from 451 the week of August 23 to 599 the week of August 30. Over the same period in Florida, tests ordered also rose by 33 percent, from 273 to 362.
While a small portion of those tests have turned up positive results, delays in testing and logging make determining a precise number difficult.
According to Natasha Hochberg, M.D., epidemiologist and co-director of the travel clinic at Boston Medical Center, this week's spike in testing could reflect the growing awareness of local transmission in Florida, the public health messaging around Zika, and the increased availability of testing.
Another likely factor, Hochberg says, is summer travel of pregnant women or their partners to and from affected areas, including Brazil, where the Olympics recently ended.
The CDC recommends that all pregnant women who have visited areas with active Zika transmission should be tested, whether or not they show symptoms of the virus. The CDC also recommends that pregnant women who live in the affected areas, such as Puerto Rico, American Samoa, and Miami-Dade County in Florida, should be tested at least twice during their pregnancies.
Florida health department workers have also been going door-to-door in Pinellas, Palm Beach, and Miami-Dade to talk to residents about the virus and offer voluntary tests. The results of those tests could increase the tally of locally acquired cases in coming weeks.
"The August 1 and August 19 CDC warnings about local transmission of Zika in the Miami area have really increased public awareness and anxiety about the virus," says Josh Gray, vice president of research at athenahealth. "As results come back from labs, the number of confirmed cases will continue to rise."
This week, officials identified Zika-infected mosquitoes in Miami Beach, so further testing is very likely. Today, Florida represents all of the nation's locally acquired Zika cases, with 35 cases confirmed. Nationwide, the CDC's tally of confirmed Zika cases, including travel associated and locally acquired, stands at 2,517.
So far, 76 percent of Zika tests are being ordered by OB/GYN and primary care physicians, athenahealth data shows. Most of those tests — 89 percent — are going to women and men ages 19 to 44. Women make up the majority of that group at 80 percent. Men in the same age range are the second-largest group, but only represent 9 percent of total tests, despite the fact that Zika can be sexually transmitted.
athenahealth has partnered with Borinquen Health Care of Miami Dade, a federally qualified health center in the midst of the area most affected, to reach out to more than 1,400 men and women who fall into at-risk age groups and may need to be tested.
Data analysis by Krishna Desai and Stewart Richardson. Chelsea Rice is a staff writer for athenaInsight.