In a move to thwart the threat of Zika, President Barack Obama asked for $1.9 billion in emergency funding from Congress in February 2016. This request, not yet approved, was followed by an Obama administration announcement Wednesday that nearly $600 million will be reallocated to assist in the Zika response.
According to the administration, this money will not be enough and the repurposing of funds, most of which had been intended for use against Ebola, is a temporary solution.
Should Congress approve a larger budget to help fight Zika? Absolutely.
As a family physician I have been taking calls from patients asking about Zika. Some are planning a destination wedding, some are awaiting a long-envisioned vacation or honeymoon, and some just want to understand how real the threat of Zika is. This is a newly emerging health threat and the truth is that every day scientists and health officials learn more about Zika. (On Thursday, the World Health Organization said it had concluded that the Zika virus causes microcephaly and Guillain-Barre syndrome, a disorder of the nervous system.)
The Zika virus is spread to people mainly through the bite of an infected Aedes species mosquito. It can also be spread from a pregnant woman to her fetus and from a man to partners through sex. Many who become infected with the Zika virus will not even know that they have contracted the disease because symptoms are often mild. They may include fever, muscle aches, eye irritation or a rash. The condition is rarely deadly and usually lasts for a few days to a week.
For pregnant women, the story is not so simple. Zika virus has been linked to infants born with microcephaly (a birth defect in which babies are born with smaller heads). In addition to microcephaly, fetuses and infants infected with Zika virus may have eye defects, hearing problems and growth retardation, among other conditions. The link between Zika virus and birth defects has become strong enough that the Centers for Disease Control and Prevention now recommends that pregnant women avoid travel to areas where Zika is spreading.
A common misconception is that Zika is a problem in “other” countries and that it is not a relevant concern for the United States. It is true that Zika is predominantly found in other countries, but the idea that it is not a concern for the United States is false. As of April 6, the CDC reported 346 travel-associated Zika virus disease cases in the United States and of these, the CDC said 32 were pregnant women and seven were sexually transmitted. Fortunately, locally acquired cases have so far not been a problem, but that could change.
As we approach the summer months, we will not only see an increase in the numbers of mosquitoes, but we also likely will see the Aedes species mosquito — the mosquito that can transmit Zika — in our backyards in some states. These mosquitoes “become infected when they feed on a person already infected with the virus” and can spread it by biting another person, according to the CDC. This mosquito can be found in many states. In addition, the number of Zika cases among travelers visiting or returning to the United States is estimated to increase. This, along with the possibility of sexual transmission, could mean that Zika could spread locally in some areas of the United States.
In February, the World Health Organization declared Zika a public health emergency of international concern. There is no vaccine to prevent Zika and there is no medication to treat it. Thus, Zika is important to address and increasing funding for the prevention and control of Zika is imperative.
To be sure, many will feel that putting extra funding toward fighting Zika is neither necessary nor relevant. At the moment, I happen to be in Puerto Rico for a medical conference. Puerto Rico has many reported cases of Zika and also has locally-acquired transmission of the virus. To take precautions, I am covering myself with bug spray, wearing long clothing and employing other preventive measures recommended by the CDC, but many people around me are not as concerned.
Some friends and colleagues (here and in the United States) have told me they feel the concerns over Zika are unnecessary and an overreaction. It is true that our greatest concern regarding Zika is with pregnant women, but that doesn’t mean it’s not an issue for all of us.
We shouldn’t overreact or be alarmist, but we should have an approach to Zika that is based on the best scientific evidence and information available. Over time, the link between the Zika virus and birth defects has become stronger, we have learned about sexual transmission and about the Aedes mosquito species (and its presence in the United States) and the possibility of local spread of the Zika virus. There is a lot that we don’t yet know about Zika. But, given what we do know, why wouldn’t we choose to prepare for Zika?
Last week, the CDC held a Zika Action Plan Summit to give state and local officials information and tools needed for Zika preparedness and response. This summit addressed many facets of managing Zika — from communication to addressing lab testing, mosquito control, outreach and surveillance. This is an appropriate and timely step to make sure we stay “ahead” of the Zika virus in the United States. Ultimately, however, states and local departments will need funding to help carry out appropriate action plans to fight Zika.
The Obama administration made the right move to begin funding a Zika response. In a White House blog post, Director of Management and Budget Shaun Donovan states, “Without the full amount of requested emergency supplemental funding, many activities that need to start now would have to be delayed, or curtailed or stopped, within months.” Given what we know about the Zika virus and its potential health consequences, we have the unique opportunity to address Zika proactively. In fact, it is our obligation. Investing in Zika preparedness and prevention should begin now and funding should be a priority.
