Being Prepared for Zika

• The Zika virus is rapidly spreading through the Americas and poses significant public health risks. Links between the Zika virus and neurological disorders and birth defects in unborn children are strongly suspected.

• Federal, state, and local governments need to work with other health organizations to share information, find tests and solutions, and make them available quickly.  

• The Senate continues to take action to ensure U.S. preparedness.

Zika in the United States

The Zika virus was first identified in 1947 in the Zika forest of Uganda. There recently has been a significant rise in Zika cases in the Americas. On February 1, the World Health Organization declared a “Public Health Emergency of International Concern.” On February 3, Florida Governor Rick Scott declared a public health emergency in four counties where the Zika virus has been detected. Travel-associated cases have also been confirmed in Arkansas, California, the District of Columbia, Georgia, Hawaii, Illinois, Massachusetts, Minnesota, New Jersey, Texas, Virginia, Puerto Rico, and the U.S. Virgin Islands. Last week, Texas officials confirmed a case of domestically contracted Zika that may have been spread by sexual contact. 

What is Zika?

Zika was historically seen in equatorial regions of Africa and Asia, where it caused a mild, flu-like illness and rash in some people. About 10 years ago, Zika outbreaks were seen in the Pacific islands. Last spring, Zika appeared in South America, and since then it has infected more than 1 million Brazilians and been identified in countries and territories throughout South America, Central America, and the Caribbean.

The virus is primarily transmitted by a type of mosquito that can be found in the southeastern United States. It is possible that Zika can also be transmitted from mother to her baby during pregnancy. On February 5, Brazilian health researchers said the Zika virus is also active in saliva and urine.

An estimated four out of five people with the virus do not display any symptoms. Of those who do display symptoms, those symptoms are usually mild – fever, joint and muscle pain, conjunctivitis, rashes, and headaches. Concerns arise, however, from apparent links between the virus and birth defects and other neurological conditions.

An important issue for women and children

Though the Zika virus symptoms are mild, it may be dangerous for pregnant women and unborn children. The virus may be linked with a serious birth defect: microcephaly. Babies born with microcephaly have small heads and often have smaller brains that may not develop properly. Microcephaly has been associated with seizures, developmental delay, intellectual disabilities, problems with movement and balance, feeding problems, hearing loss, and vision problems. At least one baby in the United States – in Hawaii – is confirmed to have been born with microcephaly. His mother contracted the Zika virus while in Brazil in May 2015.

In Brazil, the rapid spread of Zika and microcephaly has ignited a debate over the country’s strict abortion laws. Legal scholars in the country’s capital are planning to argue before Brazil’s highest court that pregnant women should be permitted to have abortions when their unborn children are found to have abnormally small heads. A judge in central Brazil has announced that he will allow women to have legal abortions where microcephaly is found. In Recife, the Brazilian city with the greatest increase in microcephaly, abortion advocates are using the crisis to fuel their advocacy. Last week, the United Nations encouraged countries affected by the virus to allow women to have abortions and use contraception.

The Centers for Disease Control and Prevention has issued guidelines for pregnant women who have traveled to, or live in, affected regions, and for men who could transmit Zika. The CDC reports that its laboratories are working around the clock to ensure the country is prepared.

Action must be taken quickly

The United States needs to be prepared to prevent Zika from rising to the level it has reached in other parts of the Americas. This will be especially important as the weather grows warmer, creating more hospitable conditions for mosquitos. It is imperative that public health agencies respond more quickly than they did following the Ebola and Avian flu outbreaks in the U.S.

In addition to microcephaly, Zika may be tied to other serious neurological problems. Guillain-Barré syndrome – a temporary but potentially debilitating neurological disease that can cause paralysis – has popped up in countries soon after the arrival of Zika.

“We know there is an increasing amount of concern about what the spread of this virus could mean for the United States as we head towards warmer months. Given the public concern that followed the first Ebola case in our country, I think we could all benefit from having a better understanding of what preparations are being made to protect Americans.” – Senator Mitch McConnell, 2/3/2016

Preparedness at the agencies

Over the past decade, Congress has worked with the Department of Health and Human Services to bolster our medical and public health preparedness and response capabilities. Congress passed in 2006, and reauthorized in 2013, the Pandemic and All-Hazards Preparedness Act, authored by Senator Burr. This law created the job of assistant secretary for preparedness and response to coordinate responses to public health emergencies and pandemics, like Zika, and required a strategy on National Public Health Preparedness and Response.

The bipartisan PAHPA put in place key programs to advance medical countermeasure research to protect the American people. It created the Biodefense Advanced Research and Development Authority to accelerate the development of diagnostics, vaccines, and drugs to respond to public health threats such as Zika. Additionally, PAHPA recognized that pregnant women and children are vulnerable populations with unique considerations. These include considerations about the development of therapies and vaccines to protect them against emerging threats. 

The National Institutes of Health is doing basic research into the virus and looking into vaccine development. The CDC is focused on identifying, educating, and responding throughout the U.S. and assisting other countries with Zika preparedness and response efforts. PAHPA also gave the Food and Drug Administration authority to support medical countermeasure development and review, including in the case of a public health threat to Americans. As part of the 2014 response to Ebola, the HHS secretary was given the authority to add the Zika virus to the ‎Neglected Tropical Disease Priority Review Voucher Program.

Recent actions taken and upcoming dates

• On January 22, the CDC released interim guidelines for health care providers in the United States for pregnant women during a Zika virus outbreak. These guidelines include recommendations for pregnant women considering travel to an area with Zika virus transmission and recommendations for screening, testing, and managing the return of pregnant women who have traveled to these regions.
• On February 1, the WHO convened an International Health Regulations Emergency Committee meeting on Zika and declared a global health emergency, which enables additional funding and research for Zika.
• On February 3, Senators Alexander and Burr wrote to HHS requesting utilization of the “priority review program” to address the Zika virus.
• On February 5, the CDC issued interim guidelines outlining prevention of sexual transmission of Zika, and the NIH announced research priorities for investigation and study of the Zika virus.
• On February 8, President Obama announced that he plans to request about $1.8 billion in new funding in response to the Zika virus.
• Today, HHS Secretary Burwell is meeting with senators to discuss the administration’s response to the virus.
• On February 11, the Senate Appropriations Committee Subcommittee on Labor, Health and Human Services, Education, and Related Agencies will hold a hearing on “Emerging Health Threats and the Zika Supplemental Request.” The directors of the CDC and the National Institute of Allergy and Infectious Diseases will testify.
• On February 16, the Institute of Medicine will hold a workshop of experts to discuss ways to counter and manage any Zika outbreak in the U.S.
• On February 24, the Senate HELP Committee will hold a hearing to discuss the Zika virus.