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Officials Preparing for Zika Virus to Spread in the U.S. Officials Preparing for Zika Virus to Spread in the U.S.
(about 5 hours later)
WASHINGTON — The federal government is preparing to release a proposal for responding to the first homegrown cases of the Zika virus, health officials said Friday. WASHINGTON — The federal government, preparing for homegrown cases of the Zika virus, is planning to release a proposal for responding to them, health officials said Friday.
The 60-page document is a blueprint for action when the first cases of locally transmitted Zika occur in the continental United States. Officials at the Centers for Disease Control and Prevention could not say when it would be made public and emphasized that it was a working draft that could change based on input from state officials. The 60-page document, a blueprint for action when the first cases of locally transmitted Zika occur in the continental United States, could be released early next week, officials at the Centers for Disease Control and Prevention said. They emphasized that it was a working draft that could change based on advice from state officials.
Sylvia Mathews Burwell, the secretary of Health and Human Services, and Dr. Thomas Frieden, the director of the C.D.C., spoke by video conference on Thursday with state governors about the plan. On Friday, experts with the C.D.C. planned to talk with state health departments. Sylvia Mathews Burwell, the secretary of health and human services, and Dr. Thomas R. Frieden, the director of the C.D.C., spoke by videoconference with state governors Thursday about the plan. On Friday, experts with the C.D.C. talked with state health departments.
The Zika virus is transmitted by the Aedes aegypti mosquito — a bug that is found in the United States mostly in the South and Southwest, though its range can spread in summer. So far no one has been infected with Zika by a mosquito in the continental United States, but health experts expect it to happen. “We know that Zika is a completely unprecedented problem and the front-line response is going to be crucial,” Dr. Anne Schuchat, the C.D.C.’s deputy director, said in an interview. “The summer is starting, and the mosquitoes are coming.”
The health experts do not expect there to be an explosive Zika virus transmission like the recent one in Brazil because many homes in the United States are air-conditioned and keep their windows closed. Many also have screened windows that keep mosquitoes out. The United States is also much less densely populated than the areas of Brazil where the outbreak of the Zika virus occurred. The Zika virus is transmitted by the Aedes aegypti mosquito — a bug that in the United States is found mostly in the South and Southwest, though its range can spread in the summer. No one has been infected with Zika by a mosquito in the continental United States, but health experts expect it to happen.
Many health experts worry, however, that a Zika virus outbreak could be difficult to fight because 80 percent of the people infected with it experience no symptoms. The health experts do not expect an explosive Zika virus transmission like the recent one in Brazil because many homes in the United States are air-conditioned and keep their windows closed. Many also have screened windows that keep mosquitoes out. The United States is much less densely populated than the areas of Brazil where the Zika outbreak occurred, a hindrance to transmission given that the Aedes aegypti mosquito rarely flies more than a block in its lifetime.
“If we have a homegrown case, that’s a game changer,” said Dr. Thomas E. Dobbs III, Mississippi’s epidemiologist, in a telephone interview. “The real challenge,” he said, is that “if only 20 percent of people have notable symptoms, what about the 80 percent who don’t?” Many health experts worry, however, that a Zika outbreak could be difficult to fight because 80 percent of the people infected with it experience no symptoms.
“If we have a homegrown case, that’s a game changer,” Dr. Thomas E. Dobbs III, Mississippi’s epidemiologist, said in a telephone interview.
Zika causes debilitating birth defects, including abnormally small heads and damaged brains from a condition called microcephaly. Health officials are focusing on protecting pregnant women from exposure to mosquitoes or people infected with the Zika virus. The disease can be sexually transmitted, too.Zika causes debilitating birth defects, including abnormally small heads and damaged brains from a condition called microcephaly. Health officials are focusing on protecting pregnant women from exposure to mosquitoes or people infected with the Zika virus. The disease can be sexually transmitted, too.
The government’s response plan includes helping states define the geographic boundaries where transmission of the virus has occurred and making sure that states reach pregnant women and their doctors in the infected areas to warn them. The C.D.C. will also make sure that any Zika-infected pregnant women are entered into the agency’s registry so the cases can be monitored and tracked after the babies are born. At the heart of the plan are the C.D.C.’s multidisciplinary rapid-response teams. They will provide state and local governments with technical and logistical expertise, epidemiology, laboratory services and advice on fighting mosquitoes. The C.D.C. has used rapid-response teams for years to track many diseases.
The C.D.C. will also deploy multidisciplinary rapid response teams. Those teams will provide technical and logistical expertise, epidemiology, laboratory services and vector control, which is the term for controlling animals or insects that transmit disease. “We know that this is a critical time,” Dr. Schuchat said. “It’s really the time to get ready.”
The C.D.C. has used rapid response teams for years to track diseases of all sorts, from E. coli outbreaks in fast-food restaurants to hospital infections. If the disease spreads like its cousins — dengue and chikungunya — experts say they expect there to be individual cases that are essentially one-offs, not large clusters that spread.
Many states have been actively preparing already. This winter, Florida declared a state of emergency in the counties that had Zika cases in people who had become infected while traveling abroad. In Mississippi, health experts have been gathering mosquito samples in five places in every county since May, Dr. Dobbs said. So far, no Aedes aegypti mosquitoes have turned up, he said. Still, Dr. Schuchat cautioned that health officials were not going to assume that Zika would behave that way.
“This has really jarred people out of any type of complacency they had,” said Joseph M. Conlon, a retired Navy entomologist who is a technical adviser to the American Mosquito Control Association, based in Mount Laurel, N.J. “They’ve gotten into planning mode big time.” “The first case is an important event,” she said. She added that it might not be immediately clear whether the case came from a local mosquito until there were several, and that doctors, hospitals and local health authorities needed to be particularly vigilant.
In states like Mississippi, where poverty and modest tax bases make mosquito control spotty, contracts with private vector-control companies are being put in place. These companies are commonly used in states that are plagued by hurricanes, Dr. Conlon said. “That first local transmission case is not going to come with a sign saying, ‘I’m the first local transmission case,’” Dr. Schuchat said.
Dr. Dobbs of Mississippi said the state was currently negotiating with two private vector-control companies. Many states have already been preparing. In Mississippi, health experts have been gathering mosquito samples in five places in every county since May, Dr. Dobbs said, but no Aedes aegypti mosquitoes have turned up.
“This has really jarred people out of any type of complacency they had,” said Joseph M. Conlon, a retired Navy entomologist who is a technical adviser to the American Mosquito Control Association. “They’ve gotten into planning mode big time.”
In states like Mississippi, where poverty and modest tax bases make mosquito control spotty, contracts with private vector-control companies are being put in place. Such companies are commonly used in states plagued by hurricanes, Dr. Conlon said.
The C.D.C. is “helping to fill the gaps,” Dr. Schuchat said. “But the states need to own the issue, and we think they really are stepping up towards that.”