Is the U.S. Ready to Combat Zika? - Pacific Standard

Is the U.S. Ready to Combat Zika?

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As warmer weather sets in, mosquitoes will follow.

By Madeleine Thomas

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(Photo: Luis Robayo/AFP/Getty Images)

On Tuesday, a baby girl with severe microcephaly, caused by the Zika virus, was born at a New Jersey hospital. She is among the first to be born in the continental United States with the condition.

The baby’s mother contracted the virus in Honduras, her home country. She was already being monitored for Zika there after a blood sample confirmed she had the virus, according to local media. The unidentified woman moved to the U.S. several weeks ago to visit relatives and to seek better medical care for her unborn child.

As many as 80 percent of people infected with Zika never show any symptoms. Those who do often experience fevers, rashes, joint pain, or conjunctivitis that can last for up a week after the initial infection. During pregnancy, the virus can pass from mother to fetus, and can lead to microcephaly, a severe birth defect that causes an unusually small head size and abnormal brain development. In some cases, Zika has also been linked to Guillain-Barre syndrome, a rare neurological condition that can result in temporary paralysis.

As summer months quickly approach — and with them, an influx of potentially Zika-carrying mosquitos — questions remain as to how prepared local, state, and federal agencies are to handle the virus. There are 591 Zika cases currently confirmed across the U.S. Of those, 168 involve pregnant women, according to the Centers for Disease Control and Prevention (CDC).

There are 591 Zika cases currently confirmed across the U.S.

“Nothing about Zika is going to be easy or quick; the control of this particular mosquito is hard, and although we’re learning a lot quickly, there is still a lot we don’t know,” Tom Frieden, director of the CDC, said in a press conference in early April. “With microcephaly the challenges are different. It is unprecedented. It has been more than 50 years since there has been a viral cause of a severe birth defect identified.”

Impoverished communities are often hit hardest by tropical diseases like Zika or Ebola. Such outbreaks can prolong the cycle of poverty, given their effects on maternal and child health, writes Peter Hotez, a pediatrician and microbiologist at Texas Children’s Hospital, and dean of the National School of Tropical Medicine at Baylor College of Medicine. “In the case of Zika … poverty equates to poor quality housing, in addition to uncollected garbage and standing water in poor neighborhoods that allow certain insects to breed nearby,” Hotez writes in an essay for PLoS Neglected Tropical Diseases.

In an April op-ed for the New York Times, Hotez goes on to describe why impoverished regions throughout the Gulf Coast and major cities like Houston could be hit hardest when the mosquitoes start to breed:

“In the Fifth Ward of Houston (a historically African-American neighborhood that was populated by freed slaves after the Civil War), just a few miles from the medical center where I work, there is an astonishing level of extreme poverty. A brief tour reveals water-filled drainage ditches in place of gutters, as well as evidence of dumping — a common practice in which people toss old tires and other garbage into residential areas rather than designated landfill sites — right next to shabby and crumbling housing.”

Without proper environmental clean-up to remove stagnant water or adequate spraying for mosquito control, doctors could start reporting cases of microcephaly throughout the Gulf Coast by the end of the year, Hotez predicts:

“This could be a catastrophe to rival Hurricane Katrina or other recent miseries that disproportionately affect the poor. Zika is a potentially devastating health crisis headed for our region, and we might have only a few weeks to stop it before pregnant women become infected.”

Zika is typically spread by the Aedes aegypti mosquito. In April, however, researchers recently detected the virus in the Aedes albopictus, or Asian tiger mosquito, for the first time — a species more common in the U.S. Regions across southern Florida and south Texas are the most likely to experience the highest numbers of Zika-carrying mosquitoes in warmer months, according to research from the National Aeronautics and Space Administration and the National Center for Atmospheric Research. Cities with high poverty rates along the U.S.-Mexico border may also experience higher rates of the virus.

The World Health Organization declared Zika an international public-health emergency in early February. Shortly thereafter, the White House sent an emergency request to Congress for more than $1.8 billion in Zika preparedness funds, including money for vaccine research and for additional health services for low-income pregnant women. House Republicans opted out of signing off on the spending, however. Instead, some $600 million in Ebola funding was diverted toward Zika research. The Senate eventually approved $1.1 billion in emergency funding in early May, following criticism from other federal agencies.

“As the White House Ebola response coordinator, I know from first-hand experience that we cannot wait until we see widespread transmission in the United States before taking steps to prepare — it’s just too late at that point,” Amy Pope, the deputy assistant for homeland security for President Barack Obama, said at a press conference in April. “We’re bringing the money to this fight, but we cannot undermine our fight against Ebola or all the other health epidemics that exist to take the fight to Zika. But let me be clear, even if we make these hard choices, the money we have now is not enough.”

Overall public-health spending nationwide has been shrinking in recent years. The CDC’s budget decreased from $7.07 billion in fiscal year 2005 to $6.34 billion in 2016, according to an April report by the non-profit Trust for America’s Health. Funding for emergency disasters has been slashed too: The budget for the federal Hospital Preparedness Program dropped more than 50 percent, from $515 million 2004 to $255 million in 2016.

In the face of more Zika cases in the U.S., the government may need to re-evaluate that budget.

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