CDC: Puerto Rico Zika cases now include 65 pregnant women, 1 death

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683 Zika cases in Puerto Rico, 1 death - CDC

CHICAGO, April 29 (Reuters) - Health officials on Friday confirmed the first U.S. death of a patient infected with the Zika virus in Puerto Rico.

The man, who was in his 70s, died from severe thrombocytopenia, a bleeding disorder caused by abnormally low blood platelets, which are needed for blood clotting.

SEE ALSO: WHO issues yellow fever warning as deadly outbreak grows

Dr. Tyler Sharp of the U.S. Centers for Disease Control and Prevention's Dengue Branch in San Juan told Reuters the patient had Zika virus disease, which included symptoms of fever, rash and body pain.

Shortly after those symptoms subsided, the man developed "bleeding manifestations" which sent him to the doctor for treatment.

Sharp said the man was diagnosed with a rare Zika complication known as immune thrombocytopenic purpura or ITP, an autoimmune disorder in which the immune system attacks blood cells, called platelets.

See photos from the Zika epidemic:

17 PHOTOS
Zika, Mosquito borne illness causing birth defects in Brazil
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CDC: Puerto Rico Zika cases now include 65 pregnant women, 1 death
RECIFE, BRAZIL - JANUARY 29: Dr. Valeria Barros treats a 6-week old baby born with microcephaly at the Lessa de Andrade polyclinic during a physical therapy session on January 29, 2016 in Recife, Pernambuco state, Brazil. Health officials believe as many as 100,000 people have been exposed to the Zika virus in Recife, although most never develop symptoms. In the last four months, authorities have recorded around 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to spread throughout nearly all the Americas. (Photo by Mario Tama/Getty Images)
RECIFE, BRAZIL - JANUARY 31: Alice Vitoria Gomes Bezerra, 3-months-old, who has microcephaly, is held by her mother Nadja Cristina Gomes Bezerra on January 31, 2016 in Recife, Brazil. In the last four months, authorities have recorded close to 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to spread throughout nearly all the Americas. (Photo by Mario Tama/Getty Images)
RECIFE, BRAZIL - JANUARY 29: David Henrique Ferreira, 5 months, who was born with microcephaly, is kissed by his mother Mylene Helena Ferreira on January 29, 2016 in Recife, Pernambuco state, Brazil. In the last four months, authorities have recorded around 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to spread throughout nearly all the Americas. (Photo by Mario Tama/Getty Images)
RECIFE, BRAZIL - JANUARY 29: David Henrique Ferreira, 5 months, who was born with microcephaly, is held by his grandmother Maria Elisabeth as his mother stands at right on January 29, 2016 in Recife, Pernambuco state, Brazil. In the last four months, authorities have recorded around 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to spread throughout nearly all the Americas. (Photo by Mario Tama/Getty Images)
Pregnant woman Angelica Prato, infected by the Zika virus, is attended at the Erasmo Meoz University Hospital in Cucuta, Colombia, on January 25, 2016. Authorities in Brazil, Colombia, Ecuador, El Salvador and Jamaica have advised couples to avoid pregnancy for the time being due to the presence of the Zika virus because if a pregnant woman is infected by the virus, the baby could be born with microcephaly. The Zika virus, a mosquito-borne disease suspected of causing serious birth defects, is expected to spread to all countries in the Americas except Canada and Chile, the World Health Organization said. AFP PHOTO/Schneyder Mendoza / AFP / SCHNEYDER MENDOZA (Photo credit should read SCHNEYDER MENDOZA/AFP/Getty Images)
RECIFE, BRAZIL - JANUARY 27: Alice Vitoria Gomes Bezerra, 3-months-old, who has microcephaly, is placed in her crib by her father Joao Batista Bezerra on January 27, 2016 in Recife, Brazil. In the last four months, authorities have recorded close to 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to spread throughout nearly all the Americas. At least twelve cases in the United States have now been confirmed by the CDC. (Photo by Mario Tama/Getty Images)
Kleisse Marcelina ,24, bathes her son Pietro, 2 month, suffering from microcephalia caught through an Aedes Aegypti mosquito bite, in Salvador, Brazil on January 28 , 2016. AFP PHOTO / Christophe SIMON / AFP / CHRISTOPHE SIMON (Photo credit should read CHRISTOPHE SIMON/AFP/Getty Images)
RECIFE, BRAZIL - JANUARY 26: Grandmother Ivalda Caetano holds Ludmilla Hadassa Dias de Vasconcelos (2 months), who has microcephaly, at Oswald Cruz hospital on January 26, 2016 in Recife, Brazil. In the last four months, authorities have recorded close to 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to spread throughout nearly all the Americas. At least twelve cases in the United States have now been confirmed by the CDC. The Brazilian government announced it will deploy more than 200,000 troops to combat the mosquitos which are spreading the Zika virus. (Photo by Mario Tama/Getty Images)
RECIFE, BRAZIL - JANUARY 27: Dr. Vanessa Van Der Linden, the neuro-pediatrician who first recognized and alerted authorities over the microcephaly crisis in Brazil, measures the head of a 2-month-old baby with microcephaly on January 27, 2016 in Recife, Brazil. The baby's mother was diagnosed with having the Zika virus during her pregnancy. In the last four months, authorities have recorded close to 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to spread throughout nearly all the Americas. At least twelve cases in the United States have now been confirmed by the CDC. (Photo by Mario Tama/Getty Images)
RECIFE, BRAZIL - JANUARY 31: Alice Vitoria Gomes Bezerra, 3-months-old, who has microcephaly, is held by her mother Nadja Cristina Gomes Bezerra on January 31, 2016 in Recife, Brazil. In the last four months, authorities have recorded close to 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to spread throughout nearly all the Americas. (Photo by Mario Tama/Getty Images)
Physical therapist Isana Santana treats Ruan Hentique dos Santos, suffering from microcephalia caught through an Aedes Aegypti mosquito bite, at Obras Socias irma dulce hospital in Salvador, Brazil on January 28 , 2016. AFP PHOTO / Christophe SIMON / AFP / CHRISTOPHE SIMON (Photo credit should read CHRISTOPHE SIMON/AFP/Getty Images)
The parents of Icaro Luis , 2 month, suffering from microcephalia caught through an Aedes Aegypti mosquito bite, Physical therapist Isana Santan at the Obras socias irma dulce hospital in Salvador, Brazil on January 28, 2016. AFP PHOTO / Christophe SIMON / AFP / CHRISTOPHE SIMON (Photo credit should read CHRISTOPHE SIMON/AFP/Getty Images)
Physical therapist Isana Santana treats Ruan Hentique dos Santos, suffering from microcephalia caught through an Aedes Aegypti mosquito bite, at Obras Socias irma dulce hospital in Salvador, Brazil on January 28 , 2016. AFP PHOTO / Christophe SIMON / AFP / CHRISTOPHE SIMON (Photo credit should read CHRISTOPHE SIMON/AFP/Getty Images)
Ana Paula Santos, 34, holds her 45-day-old daughter Flavia Alessandra suffering from microcephalia supposedly caught through an Aedes aegypti mosquito bite, at the Obras Sociais Irma Dulce hospital in Salvador, Brazil on January 27, 2016. AFP PHOTO / Christophe SIMON / AFP / CHRISTOPHE SIMON (Photo credit should read CHRISTOPHE SIMON/AFP/Getty Images)
RECIFE, BRAZIL - JANUARY 25: Estafany Perreira holds her nephew David Henrique Ferreira, 5 months, who has microcephaly, on January 25, 2016 in Recife, Brazil. In the last four months, authorities have recorded close to 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. Microcephaly results in newborns with abnormally small heads and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to further spread in South, Central and North America. At least twelve cases of Zika in the United States have now been confirmed by the CDC. (Photo by Mario Tama/Getty Images)
RECIFE, BRAZIL - JANUARY 25: Mother Mylene Helena Ferreira cares for her son David Henrique Ferreira, 5 months, who has microcephaly, on January 25, 2016 in Recife, Brazil. In the last four months, authorities have recorded close to 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. Microcephaly results in newborns with abnormally small heads and is associated with various disorders including decreased brain development. According to the World Health Organization (WHO), the Zika virus outbreak is likely to further spread in South, Central and North America. At least twelve cases of Zika in the United States have now been confirmed by the CDC. (Photo by Mario Tama/Getty Images)
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Sharp said the ITP case followed the same pattern as patients with Guillain-Barre Syndrome, a paralyzing neurological disorder linked to Zika infections in which the immune system attacks nerves. In both cases, the autoimmune attack occurs after symptoms of Zika have cleared.

Sharp said researchers are studying how Zika causes these rare disorders, and are looking to see whether they are caused by the same mechanism.

"We are actively investigating that. It's very interesting scientifically. But this is something that is a significant cause of morbidity and now mortality here in Puerto Rico, where I live. These are my neighbors. It's of high public health importance that we figure this out and as quickly as we can design some interventions to stop it," Sharp said.

The death in Puerto Rico is the first U.S. Zika-related death. Previously, Colombia reported three deaths among Zika patients who had symptoms consistent with ITP, Sharp said.

Suriname has also reported one case of Zika-related ITP, and French Polynesia reported four such cases, but all of these patients survived.

These 50 cities are at the highest risk for Zika:

51 PHOTOS
50 cities with the most risk for Zika
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CDC: Puerto Rico Zika cases now include 65 pregnant women, 1 death

#50. Midland, Texas

Risk level: 1.38

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 161,290

Photo courtesy: Getty

#49. Yuma, Ariz.

Risk level: 1.38

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 203,247

Photo courtesy: Getty

#48. Laredo, Texas

Risk level: 1.38

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 266,673

Photo courtesy: Getty

#47. El Paso, Texas

Risk level: 1.41

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 836,698

Photo courtesy: Getty

#46. Bakersfield, Calif.

Risk level: 1.42

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 874,589

Photo courtesy: Getty

#45. Albuquerque, New Mexico

Risk level: 1.42

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 904,587

Photo courtesy: Getty

#44. Tucson, Ariz.

Risk level: 1.42

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,004,516

Photo courtesy: Getty

#43. Salt Lake City, Utah

Risk level: 1.43

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,153,340

Photo courtesy: Getty

#42. Fresno, Calif.

Risk level: 1.93

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 965,974

Photo courtesy: Getty

#41. Las Vegas, Nev.

Risk level: 1.99

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 2,069,681

Photo courtesy: Getty

#40. Sacramento, Calif.

Risk level: 2

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 2,244,397

Photo courtesy: Getty

#39. San Antonio, Texas

Risk level: 2.03

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 2,328,652

Photo courtesy: Getty

#38. Denver, Colo.

Risk level: 2.2

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 2,754,258

Photo courtesy: Getty

#37. San Diego, Calif.

Risk level: 2.4

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 3,263,431

Photo courtesy: Getty

#36. Phoenix, Ariz.

Risk level: 2.89

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 4,489,109

Photo courtesy: Getty

#35. Montgomery, Ala.

Risk level: 3.92

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 373,141

Photo courtesy: Getty

#34. Huntsville, Ala.

Risk level: 3.94

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 441,086

Photo courtesy: Getty

#33. Shreveport, La.

Risk level: 3.95

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 445,142

Photo courtesy: Getty

#32. Fayetteville, Ark.

Risk level: 3.97

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 501,653

Photo courtesy: Getty

#31. Jackson, Miss.

Risk level: 4

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 577,564

Photo courtesy: Getty

#30. Augusta, Ga.

Risk level: 4

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 583,632

Photo courtesy: Getty

#29. Little Rock, Ark.

Risk level: 4.24

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 729,135

Photo courtesy: Getty

#28. Columbia, SC

Risk level: 4.36

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 800,495

Photo courtesy: Getty

#27. Birmingham, Ala.

Risk level: 4.93

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,143,772

Photo courtesy: Getty

#26. Raleigh, NC

Risk level: 5.09

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,242,974

Photo courtesy: Getty

#25. Richmond, Va.

Risk level: 5.12

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,260,029

Photo courtesy: Getty

#24. Louisville, Ky.

Risk level: 5.13

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,269,702

Photo courtesy: Getty

#23. Oklahoma City, Okla.

Risk level: 5.25

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,336,767

Photo courtesy: Getty

#22. Memphis, Tenn.

Risk level: 5.26

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,343,230

Photo courtesy: Getty

#21. Nashville, Tenn.

Risk level: 6

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,792,649

Photo courtesy: Getty

#20. Kansas City, Mo.

Risk level: 6.04

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 2,071,133

Photo courtesy: Getty

#19. St. Louis, Mo.

Risk level: 6.13

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 2,806,207

Photo courtesy: Getty

#18. Dallas, Texas

Risk level: 7.11

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 500,000-1,000,000
Population: 6,954,330

Photo courtesy: Getty

#17. Charlotte, NC

Risk level: 7.38

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 2,380,314

Photo courtesy: Getty

#16. Washington, D.C.

Risk level: 7.86

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 6,033,737

Photo courtesy: Getty

#15. Philadelphia, Pa.

Risk level: 7.86

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: 10,000-500,000
Population: 6,052,170

Photo courtesy: Getty

#14. Los Angeles, Calif.

Risk level: 7.93

Mosquito level in January: None
Mosquito level in July: Low
Number of people traveling to the U.S. from Zika countries: 500,000-1,000,000
Population: 13,262,220

Photo courtesy: Getty

#13. Savannah, Ga.

Risk level: 7.99

Mosquito level in January: None
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 372,708

Photo courtesy: Getty

#12. Tallahassee, Fla.

Risk level: 7.99

Mosquito level in January: None
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 375,751

Photo courtesy: Getty

#11. Mobile, Ala.

Risk level: 8

Mosquito level in January: None
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 415,123

Photo courtesy: Getty

#10. Charleston, SC

Risk level: 8

Mosquito level in January: None
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 727,689

Photo courtesy: Getty

#9. New Orleans, La.

Risk level: 8.01

Mosquito level in January: None
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,251,849

Photo courtesy: Getty

#8. Atlanta, Ga.

Risk level: 8.13

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: 500,000-1,000,000
Population: 5,614,323

Photo courtesy: Getty

#7. Houston, Texas

Risk level: 8.14

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: 500,000-1,000,000
Population: 6,490,180

Photo courtesy: Getty

#6. Jacksonville, Fla.

Risk level: 8.38

Mosquito level in January: Low
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 1,419,127

Photo courtesy: Getty

#5. New York, NY

Risk level: 8.49

Mosquito level in January: None
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: 1,000,000-2,000,000
Population: 20,092,883

Photo courtesy: Getty

#4. Brownsville, Texas

Risk level: 8.86

Mosquito level in January: Low
Mosquito level in July: Moderate
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 420,392

Photo courtesy: Getty

#3. Tampa, Fla.

Risk level: 9.14

Mosquito level in January: Low
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: <10,000
Population: 2,915,582

Photo courtesy: Getty

#2. Orlando, Fla.

Risk level: 9.43

Mosquito level in January: Low
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: 500,000-1,000,000
Population: 2,321,418

Photo courtesy: Getty

#1. Miami, Fla.

Risk level: 10

Mosquito level in January: Moderate
Mosquito level in July: High
Number of people traveling to the U.S. from Zika countries: 1,000,000-2,000,000
Population: 5,929,819

Photo courtesy: Getty

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Although deaths from Zika are rare, the Puerto Rico death "highlights the possibility of severe cases, as well as the need for continued outreach to raise health care providers' awareness of complications that might lead to severe disease or death," researchers said in a report published in the CDC's Morbidity and Mortality weekly Report.

In addition to the Zika-related death, Puerto Rico reported 683 confirmed cases of Zika, including 65 pregnant women with symptoms of the virus, the CDC said on Friday.

Of the confirmed cases, five patients developed Guillain-Barre syndrome and were hospitalized.

Zika, a virus known to cause the birth defect microcephaly, first began spreading in Puerto Rico in December.

In Brazil, Zika has been linked to 1,198 confirmed cases of microcephaly, a rare birth defect marked by small head size that can lead to severe developmental problems in babies. Zika has also been linked to other severe birth defects and with stillbirth.

The World Health Organization declared Zika a global health emergency on Feb. 1. In addition to microcephaly, the agency says there is a strong scientific consensus that Zika can cause Guillain-Barre, a rare neurological syndrome.

U.S. health officials said Zika remains a public health threat in Puerto Rico, with more cases expected throughout 2016.

Residents of and travelers to Puerto Rico are urged to take steps to avoid mosquito bites including the use of mosquito repellent, take precautions to reduce the risk of sexual transmission of Zika, and seek medical care for any acute illness with rash or fever.

(Reporting by Julie Steenhuysen; Editing by Bernard Orr)

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