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Senate committee hears testimony on state of Zika virus

The U.S. Senate Committee on Health, Education, Labor and Pensions recently heard testimony from public health officials on the growing public health threat of Zika virus to help Congress and the public gain a better understanding of the virus and the threat it poses to the United States.

Testimony was given by Anne Schuchat, MD, principal deputy director of the CDC; Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, and Robin Robinson, PhD, director of the Biomedical Advanced Research and Development Authority.

Anne Schuchat

Schuchat justified the Obama administration’s $1.9 billion emergency funding request during her testimony by emphasizing the need for more research to fully understand and combat Zika virus.

“While we are learning more about the Zika virus every day, there are many things we do not know yet,” Schuchat said. “These include our understanding of the spectrum of effects of Zika infection during pregnancy, the risk the virus may play in microcephaly, Guillain-Barré syndrome and other possible complications, the duration of Zika infectivity in semen and determining what other factors may play a part in the consequences associated with the virus.”

According to Schuchat, the CDC is basing its preparedness and response strategies on previous outbreaks of similar viruses.

“We have to be prepared for different scenarios,” Schuchat said. “Most of what we think will happen is based on what we have seen with dengue and chikungunya, which are endemic in much of Latin America, but they are not endemic in the continental United States. So the trajectory we think we will see [with Zika] is based on what we have seen with them.”

During the hearing, Fauci elaborated on NIAID’s current research on Zika, which includes investigation into advancements in diagnostics, vaccines, therapeutics and vector control. Fauci also warned that emerging infectious diseases like Zika will always pose a threat to the health of Americans, and therefore require continued research support.

“Emerging infectious diseases have been around forever, are around now and will always be around — and it is very important for us to address this perpetual challenge,” Fauci said.

Anthony S. Fauci

Robinson also shared similar sentiment while explaining BARDA’s strategy for advancing production of Zika diagnostic and vaccine candidates by using response techniques learned during the H1N1 and Ebola outbreaks. 

“Our foremost concern is protecting public health from known or emerging threats,” Robinson said. “Zika is our newest threat, but not our last. Congressional approval of the administration’s approximately $1.9 billion funding request will ensure an effective and rapid response to outbreaks that threaten the health of the American people and can accelerate our ability to prevent, detect, and respond to Zika and other emerging infectious diseases.”

Senate committee inquiry

Questions from the Senate committee focused on understanding the basics of Zika virus in order to gauge the need for emergency funding. Committee Chairman Sen. Lamar Alexander, R-Tenn., questioned the witnesses on the strength of the association between microcephaly and Zika infection.

“[The association] is really quite strong,” Fauci said. “When we finish cohort and case-control studies, we will be able to say that it is definitive. The evidence is literally every week, accumulating and getting stronger and stronger. If you look at the work that has been done by the CDC, together with Brazilians, looking at stillborns, miscarriages, individuals who delivered and amniotic fluid examinations, there have been several instances of whole virus demonstrated in the brains of these babies.”

Fauci also stated that confirmation on whether microcephaly is caused by Zika is a matter of months, not years, away.

In response to a question from Alexander regarding how Americans who suspect they are infected can be diagnosed, Schuchat clarified that diagnostic capabilities are limited to individuals who are either symptomatic or women who are pregnant and have traveled to a Zika-endemic region. Those tests require doctors to send samples to local health departments, which can then forward them to the CDC for diagnostic testing.

Susan Collins, R-Maine, asked the witnesses how America can plan better responses in advance of outbreaks in order to prevent the need for reactive emergency strategies.

“We seem to have a system where we are constantly scrambling to put together plans and emergency funding in order to counter these emerging threats,” Collins said. “Yet, as Dr. Fauci said, they are perpetual and are always going to be coming at us.”

“We cannot predict every single pathogen or what nature will do, but we can prepare,” Schuchat said. “But no one was expecting a birth defect to be linked to a new virus spread by mosquitoes. So we really need to look at this systematically, for the long haul, because we will have more threats, and we will have them at the same time. We won’t be lucky enough to have one at a time.”

Elizabeth Warren, D-Mass., stated that America’s deficiency in disease preparedness is due to the lack of increased funding for the NIH, BARDA and the CDC over the past decade.

Elizabeth Warren

“Each time a new disease threat appears, Congress gets very interested, and it holds hearings like this, but Congress doesn’t show the same interest in taking steps before these crises occur to make sure that our country is actually prepared when disasters strike,” Warren said. “The most effective work for keeping Americans safe doesn’t happen when the cameras are rolling and the world is focused on the latest outbreak. The real work happens every day… and that work requires real money. It requires new mandatory funding for the NIH … and until then, our response to the latest crisis will always be too little, too late.” – by David Costill

Disclosure: The researchers report no relevant financial disclosures.