Zika has already become a significant health issue in Puerto Rico, where there have been more than 5,500 infections. More than 600 of these infections have been in pregnant women. The outbreak has also set off massive public debates on the island regarding everything from insecticides to the structure of local government. It was inevitable that Zika would eventually appear in the mainland United States. Still, it couldn’t help but be surprising to see a CDC warning about travel by pregnant women to two counties (Miami-Dade and Broward) in Florida. It’s important to keep this news in perspective. So far only 14 people have been reported to have locally acquired Zika, in a very restricted geographic area in Miami. Mosquito control activities have gone into high gear in this area. One can hear an audio copy of the briefing about this news here on the CDC website. The CDC also has a dedicated webpage on Zika, which is a helpful site for information regarding the epidemic.
At the same time, health professionals are still learning a lot about this outbreak. There has been a case in Utah where a patient spread the virus to a family caregiver by unknown means. More importantly, although the virus is primarily spread by bites of the Aedes species mosquito (Ae albopictus and Ae. aegypti) recent information suggests that it can be carried by a more common mosquito. It is unknown yet whether this mosquito can effectively transmit the virus. We’ve only known for a fairly short period of time that Zika can also be spread by sex. There have also been some positive discoveries, such as that women infected late in their pregnancy seem to be at low risk. There will be more surprises and discoveries in the year to come.
Zika will be with us for a long time. This map on NPR gives us a good sense of the areas in the United States most likely to be affected. California, Arizona, Texas and Florida are obviously the states at greatest risk, as well as perhaps Maryland and Washington, DC. What is most appalling is that local health programs are being cut as the outbreak has reached the mainland United States, because of political debates within Congress. Republicans added riders to a bill to fight Zika regarding everything from the Confederate flag to contraception. Fighting Zika, and developing a vaccine, shouldn’t be a political football tied to birth control or the political memory of the Confederacy. Now that the virus has arrived, there needs to be political urgency around this issue and adequate funding for mosquito control, testing, and vaccine development.
Shawn Smallman, 2016