CDC Says Funds to Fight Zika Nearly Exhausted; “Do-Nothing” Congress on Hot Seat after Recess

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The Centers for Disease Control and Prevention is almost out of money to fight the Zika virus, the agency’s director, Dr. Thomas Frieden, said Tuesday–just hours before Florida announced three additional, locally transmitted cases of the infection.

Zika has now infected 46 people locally in Florida, presumably spread by mosquitoes, according to a report by nbcnews.com. One case is part of an outbreak in Miami Beach and health officials say they’re trying to trace the origins of two others.

“Basically, we are out of money and we need Congress to act,” Frieden told reporters. “The cupboard is bare.”

The CDC had spent as of Friday $194 million of the $222 million it was given to fight the virus. Last February, President Barack Obama asked Congress for $1.9 billion in emergency funds to fight Zika.

CDC is borrowing from other vital programs to fight the #ZikaVirus Click To Tweet

Congress has resisted, with controlling Republicans saying they want more accountability for the money and saying health agencies like the CDC and National Institutes of Health need to find money left over from fighting Ebola and other projects. Democrats turned down a Republican plan that would give the CDC and NIH some money but would take money away from Planned Parenthood.

Congress comes back from a seven-week summer break next Tuesday and agencies are lined up to demand quick action. “What will happen at the end of September is the fiscal year ends,” Frieden said.

There are no hints from the Republican-controlled House on how the federal budget will be renewed. Frieden said the CDC did repurpose tens of millions of dollars. Of the $222 million allocated for Zika, $200 million is “already out the door,” Frieden said. “That money is already spoken for.” He said $197.3 million had actually been spent.

The CDC has spent a sizeable chunk in Puerto Rico, where Zika has caused a full-blown epidemic. Travelers have brought the virus to nearly all the U.S. states, and those where Aedes aegypti mosquitoes are common–26 in all–risk outbreaks if any infected travelers get bitten. Florida has had two outbreaks and two dozen other single cases. Texas and other Gulf states are highly vulnerable, as well.

“It’s still the peak of mosquito season. It usually doesn’t end until the end of October,” Frieden said. “Unfortunately, we will see large numbers of infected infants in the coming weeks and months.”

The CDC is trying to track every single pregnant woman with Zika. So far, it’s watching 584 in the U.S. states and another 812 in the territories, mostly Puerto Rico.

“Already, there have been 16 infants born in the continental U.S. with Zika. That number will increase,” Frieden said. “The numbers in Puerto Rico will likely be substantial.”

Add to this a population uneasy about the use of insecticides, mosquito repellent and high-tech modified mosquitoes to fight the biting bugs, and it’s one complex battle. Frieden said the CDC needs money to develop better tests for the virus, to help the NIH work on a vaccine, to study babies born to women infected and to defend as much as possible against more importations of the virus.

“We are at the point where actions that are taken in the current time will have implications for decades to come,” Frieden said. “There are a lot of things that we cannot do for lack of resources.”

He said CDC is already borrowing from other vital programs.

“We have had to take money from areas including emergency preparedness in the United States, Ebola immunization programs, HIV, and monitoring disease,” he said.

The CDC took $38 million from Ebola funding and $44 million from emergency response funding.

“We have sent well over $100 million to states, territories and tribal health departments,” Frieden added. Frieden said the CDC has giving Florida everything they asked for and needed. “But at this point, we don’t have any more resources to provide them,” he said. “We’ve spent money for mosquito control, both in Puerto Rico and elsewhere.”

If Zika breaks out in Texas, in October for example, the CDC may not be able to send in response teams or supplies, Frieden said.

“We might not have the resources to do that. The speed of the clock ticking in Congress is not the same speed as a clock ticking with an epidemic.”

Steve’s Take: I’ve been reporting on the Zika story for over six months now and am actually quite excited about the impending return of Congress this coming Tuesday.

Most likely, we’ll immediately learn whether our representatives will reload their “do nothing” mindset in the face of an acknowledged health crisis and resume the tawdry, partisanship that has placed their ineptitude on stage for all the world to see.

Steve's Take: Partisanship needs to stop in order to restore funding to fight the #ZikaVirus Click To Tweet

After all the mostly negative press and with elections looming in several months, it’s unthinkable  that a “not my problem” demeanor of our federal leadership will result in mostly intelligent women and men simply resuming endless, meaningless wrangling.

But let’s look at what else happened at the start of this week that hopefully will spur our Congressional reps to responsible action.

Florida health officials on Tuesday said they were investigating three new Zika virus cases likely stemming from local mosquito bites in Miami-Dade County, including two cases outside of the known areas of active transmission, according to Reuters. The new infections bring the state’s total of non-travel-related cases to 46, according to the Florida Department of Health.

Only one of Tuesday’s three new cases was linked to Miami Beach, which is known to be an active area for local Zika transmission. The department said it believes ongoing transmission is only taking place in parts of Miami Beach and the tony Miami neighborhood of Wynwood, the site of the first local Zika transmission in the United States.

So Zika is not only here in the U.S., but transmission of the virus by mosquitoes in the Miami area is more widespread than originally thought.

Then Bloomberg News reported that mosquitoes can pass the Zika virus along to future generations in their eggs. That means winter may not stop Zika’s spread. But, wasn’t that supposed to be our salvation from the epidemic?

Nope.

Researchers have found that infected female mosquitoes can transmit the virus along to their offspring, according to a new study published in the Journal of Tropical Medicine and Hygiene.

That means that even once it gets too cold or dry for adult mosquitoes, their eggs–which can easily survive the dry season or winter–can hatch the next spring when it rains, producing Zika-infected larvae that grow into infected mosquitoes.

The Aedes aegypti, the mosquito known to carry Zika, is a creature of warm weather. But the study found that the virus, like mosquito eggs, has no such climate restrictions.

“[Transmission to offspring] is a mechanism to allow the virus to survive from one season to another,” said researcher Robert Tesh, who chairs the pathology department at the University of Texas Medical Branch in Galveston. “This is one way for the virus to survive when there are no adult mosquitoes.”

The only way mosquitoes were previously known to transmit the virus was by biting an infected human.

In their study, UTMB researchers began with two colonies of Zika-free mosquitoes–one of Aedes aegypti, and one of Aedes albopictus, which has not been connected to the virus. Then they infected some females of each. Once these females laid eggs, the adults were removed and frozen, while the eggs were allowed to hatch. This next generation of mosquitoes was allowed to grow into adulthood before being frozen, processed and tested.

None of the Aedes albopictus offspring were infected, but the Aedes aegypti offspring were infected at an estimated rate of one in 290. That’s a relatively low level of vertical transmission, Tesh says, referring to the passing of the virus from one generation to the next, and what happens in a laboratory doesn’t always translate to the real world. But Tesh expects that vertical transmission of Zika from adult mosquito will. “This probably does occur in nature,” he said.

Common methods to kill adult mosquitoes, like spraying, do not work on eggs. Eggs can be destroyed to stop them from hatching Zika-infected larvae–for instance, by adding certain bacteria to the standing water where they were laid–but it’s difficult.

“They’re so tiny,” Tesh said, “if they’re on a dark surface, you won’t see them.”

For months I and others have been doing our impression of the broken record player, urging you to contact your representatives and plead with them to provide sufficient funding to help make a Zika vaccine.

Some of these hard-to-fathom professional politicians may have gauged their timing to be most propitious (to their careers) by waiting to finally act responsibly until the official summer recess next Tuesday. Well, they may be expecting hurrahs from their constituents, but they won’t get one from me.

I think back to Dr. Frieden’s quote earlier in this piece. As CDC Director, he’s someone who knows what’s really going on with the spread of Zika.

He said: “The speed of the clock ticking in Congress is not the same speed as a clock ticking with an epidemic.”

But don’t they know that?

Addendum: Florida announced on Thursday that, for the first time, mosquitoes in Miami Beach had tested positive for the Zika virus, a disappointing confirmation that the virus is still active in the area.

The Aedes aegypti mosquito that spreads Zika is famously difficult to fight, and experts often say that testing the bugs to find the virus is like looking for a needle in a haystack. The three samples that tested positive all came from a 1.5-square-mile area in Miami Beach where locally acquired cases of Zika had been confirmed.

The significance of the results depends on where the mosquitoes were collected, said Scott C. Weaver, the director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch.

If they are from in or around the houses of people with active infections, the chances of the insects being infected are higher. If the virus was found in mosquitoes in a more distant location, that could point to a bigger infection area than thought. (Source: The New York Times)