Zika in the US: Resources from CDC, disappointing responses from lawmakers

As summer approaches, mosquito bites will become common, and the Zika virus could start spreading in parts of the continental US. Although federal, state, and local public health officials are working hard to address this threat, the response from many lawmakers has been disappointing and, in some cases, erected barriers to successful research. Here are a few updates:

CDC News and Resources: On April 1, CDC hosted a Zika Action Plan (ZAP) Summit to help states "prepare for the likelihood of mosquito-borne transmission of the Zika virus in some parts of the continental United States." (Transmission is already ongoing in Puerto Rico, US Virgin Islands, and American Samoa. So far, cases in the continental US have all been related to travel -- either because those infected with the virus traveled to countries with active Zika transmission or because the virus was sexually transmitted from travelers.) As Lisa Schnirring reports for CIDRAP, the summit featured several CDC resources for health departments, such as Zika preparedess and response guidance and templates for action plans.

CDC Director Tom Frieden told members of the media that a lack of funding will hamper the overall response effort, and that technical challenges and a patchwork of mosquito-control arrangements will make it hard to control the insects that spread Zika. (For more on the patchwork problem, see pieces from Maryn McKenna at Germination and Sabrina Tavernise in the New York Times.) Shortly before the summit, CDC updated its estimates for the range of the Aedes aegypti mosquito, which seems to be the main Zika carrier, and the Aedes albopictus, which could also spread the virus. The ranges extend farther north than previously thought, and include Washington, DC. Maybe if members of Congress are at risk of Zika infection they'll be more forthcoming with funding.

Federal Funding for Zika Response: In February, the Obama administration asked Congress for $1.9 billion for the Zika response; funds would support mosquito control, disease testing, vaccine development, and support for maternal health. Members of Congress insisted that administration first use unspent funds appropriated for Ebola response -- namely, "$600 million that was intended to help 30 countries improve, and in some cases build, public health systems to make them better prepared to fight future infectious diseases," report David Nather and Dylan Scott at STAT. (Note to lawmakers: Just because an outbreak of a disease tapers off doesn't mean you should stop funding related public-health efforts; investments in preparedness now will help limit the damage from the next outbreak.) On April 6, White House Budget Director Shaun Donovan explained that the administration was shifting funds from Ebola to Zika, but that this would only serve as a temporary stopgap:

Faced with this urgent need, we have identified $589 million – including $510 million of existing Ebola resources within the Department of Health and Human Services and Department of State/USAID – that can quickly be redirected and spent on immediate, time-critical activities such as mosquito control, lab capacity, development of diagnostics and vaccines, supporting affected expectant mothers and babies, tracking and mapping the spread and effects of Zika infections in humans, and other prevention and response efforts in the continental United States, Puerto Rico, other U.S. Territories, and abroad, especially within the Americas.

We have always said that we were open to using a portion of the existing Ebola balances for Zika, but that this alone would not provide a sufficient enough response to the significant threat posed by Zika. This remains true. As such, the redirected funds are not enough to support a comprehensive Zika response and can only temporarily address what is needed until Congress acts on the Administration's emergency supplemental request.

State Laws Hindering Zika Research: Brett Norman reports for Politico that, according to several scientists, the growing list of state laws banning donation of aborted tissue and/or research on such tissue can thwart Zika research. “Basically the only insights we’ve had so far on Zika is with patients who have either lost a pregnancy or had miscarriages,” Patrick Ramsey, an obstetrician at the University of Texas Health Science Center in San Antonio, told Norman. “This is a situation where the vaccine is going to have to protect the mom and protect the baby. Fetal tissue is going to be needed to look at the effects.” Florida Governor Rick Scott just signed into law a bill that prohibits donating aborted tissue (among other provisions that will harm women's health) even though, as Norman notes, its one of the states facing the greatest Zika risk.