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Officials raise concerns over Zika during White House briefing
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The primary vector of Zika virus, the Aedes aegypti mosquito, is more widespread in the United States than previously thought, raising concerns that the virus could become locally transmissible here, health officials said.
The officials spoke during a press briefing on April 11 at the White House amid growing fears about the virus and its effects, particularly on pregnant women and their unborn children.
Anne Schuchat
“We continue to be learning (about Zika virus) pretty much every day, and most of what we are learning is not reassuring,” Anne Schuchat, MD, principal deputy director of the CDC, said during the briefing.
Vector found in 30 states
According to the CDC, there have been 346 reported cases of Zika virus in the United States since the beginning of 2015 — all travel related. Meanwhile, 351 of the 354 Zika virus cases reported in the U.S. territories of American Samoa, Puerto Rico and the U.S. Virgin Islands were locally acquired, according to the CDC.
Schuchat said A. aegypti can be found in 30 U.S. states — far more than the 12 states previously thought to harbor the mosquito, increasing the possibility that the disease will become locally transmissible.
“Everything we look at with this virus seems to be a bit scarier than we initially thought,” she said. “So while we absolutely hope we don’t see widespread local transmission in the continental U.S., we need the states to be ready for that.”
As evidence mounts that Zika virus is associated with microcephaly and other grave outcomes in unborn children, the CDC has warned that women with symptoms should wait at least 8 weeks after symptom onset before attempting to get pregnant. In recent guidelines, the CDC also urged that men abstain from unprotected sex for at least 6 months after the onset of their symptoms, and that couples who do not exhibit symptoms but who had possible exposure to the virus from recent travel or sexual contact wait at least 8 weeks before trying to conceive.
According to Schuchat, the virus could potentially present problems throughout the course of a pregnancy, instead of just the first trimester as previously thought.
Anthony S. Fauci
Schuchat was joined in the White House press briefing room by Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.
“The more we learn,” Fauci said, “the more you get concerned about the scope of what this virus is doing. The bottom line is we still have a lot to learn.”
The Obama administration has asked Congress for $1.8 billion to battle Zika virus. While it waits for a response, the White House announced last week that around $589 million from other areas of the administrative budget would be repurposed to fight Zika, including $510 million that was previously allocated to combat Ebola virus, which an administration official said would weaken efforts in West Africa without additional support.
Figure 1. According to the CDC, 346 travel-associated cases of Zika virus were reported in the United States since 2015. Meanwhile, 354 Zika virus infections were reported in other U.S. territories, 351 of which were locally-acquired cases.
Source: CDC
According to Schuchat, the CDC is “quite concerned” over the presence of Zika virus in Puerto Rico, the hardest hit area of any U.S. state or territory. The health agency believes there potentially could be hundreds of thousands of cases of Zika, and hundreds of affected babies, Schuchat said.
The CDC is offering support through mosquito control and the distribution of Zika prevention kits for pregnant women.
“We know that the pregnant women in Puerto Rico are very keen to protect themselves and to have community protection, and we’re working closely with the authorities in Puerto Rico to support that response,” Schuchat said.
According to Fauci, the first vaccine candidate for Zika virus is still on track to begin a phase 1 trial in September. Further, Fauci said 62 drugs have been screened for treatment of Zika, and 15 have shown “some degree of activity.”
“That doesn’t mean they’re going to turn out to be good drugs,” Fauci said, “but they do have some activity.”
Recent study forecasted potential outbreak areas
Researchers recently determined that parts of Florida and Texas are more susceptible to local outbreaks of Zika than anywhere else in the U.S. due to climate, a strong potential for travel-related virus introduction and other factors.
For local transmission to occur, Zika would have to be introduced by travelers or mosquitoes infected with the virus and become sustained in local A. aegypti populations.
Southern cities in Florida and Texas can sustain low-to-moderate populations of A. aegypti even during winter months, the researchers reported, making local transmission of Zika a year-round possibility.
The researchers noted that each of the 50 U.S. cities in their study, which included areas from New York to the California coast, had the potential to support A. aegypti during peak summer months, although not every city has documented populations of the mosquito. – by Gerard Gallagher
References:
Monaghan AJ, et al. PLoS Curr. 2016;doi:10.1371/currents.outbreaks.50dfc7f46798675fc63e7d7da563da76.
Oster AM, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.mm6512e3.
Petersen EE, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.mm6512e2.
Tepper NK, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.mm6512e1.
Disclosures: Schuchat is principal deputy director of the CDC. Fauci is director of the National Institute of Allergy and Infectious Diseases.