Experts Urge United States to be Proactive, Not Reactive, in Response to Zika


Opinion polls indicate the general public remains relatively unconcerned about the threat of Zika, despite the existence of confirmed cases in the United States.

They say all politics is local.

So, too, apparently, are concerns regarding the Zika virus as summer mosquito season approaches, particularly in the southeastern part of the United States.

In March, President Obama proposed that $1.9 billion be allocated toward preventing Zika outbreaks in high-risk parts of the country—including Florida, Alabama, Louisiana, Mississippi, and Georgia—and managing already-identified outbreaks that are local in origin or traced to people who have traveled to regions of the Caribbean and South America, where the virus is prevalent. At press time, Congress has yet to approve and allocate the funds, however.

“Aggravatingly, the United States tends to be reactive, not proactive, in its response to emerging infectious diseases,” John Lednicky, PhD, associate professor, College of Public Health and Health Professions, University of Florida, told Contagion. “It is important not to be alarmist, but a balance needs to be attained between that and complacency. In the latter situation, sometimes by being reactive, our response comes late, when there is a widespread problem.”

Interestingly, opinion polls indicate the general public remains relatively unconcerned about the threat of Zika, despite the existence of confirmed cases in the United States. ABC News recently reported that a poll conducted by the Kaiser Family Foundation (KFF), for example, found that only 34 percent of Americans surveyed were worried that they or someone in their family could be diagnosed with the virus. To put that in perspective, this is roughly half the number of people who expressed fears regarding Ebola in another KFF poll conducted in the fall of 2014, despite the fact there were only three confirmed cases of the deadly African virus in the United States, and none of them were contracted locally.

Conversely, according to John C. Beier, ScD, Chief, Division of Environment and Public Health, University of Miami Miller School of Medicine, the threat of a Zika virus outbreak in the United States—particularly in warm-weather states such as Florida—is “very real.” Dr. Beier and his colleagues at the University of Miami recently held a symposium on the virus that was well attended and received significant coverage in the consumer press.

Indeed, both Drs. Beier and Lednicky—among others—agree that the United States needs to allocate funds to combat Zika, and to do so sooner rather than later. Part of the reason the public seems relatively unconcerned about the virus to date, experts believe, is that the threat has received only a fraction of the media coverage Ebola received in 2014. Any efforts to combat Zika here, they say, need to start with educational outreach.

“The public needs to learn more about the virus and the dangers that it poses,” said Dr. Lednicky, before adding that he is getting some 10,000 calls and emails a day from “private citizens” asking about Zika and “how to protect themselves from [the virus] and how to keep the mosquitoes away from their homes.” In addition, travelers to regions in which the virus is prevalent—such as Brazil and Puerto Rico— “still do not know the risks of Zika, and it is interesting to note that more than a few people who have returned to the United States with active Zika infections are missionaries or medical providers [who] we expect would know how to protect themselves from Zika,” Dr. Lednicky noted.

Public health experts also urge funding for preventive measures such as active and passive surveillance protocols for the virus and any outbreaks. Dr. Lednicky told Contagion that his colleagues in the University of Florida’s Emerging Pathogens Institute and the Department of Environmental and Global Health found that Zika virus was present in Haiti in 2014, but that “there was little to no interest in our discovery.” He believes that had funds been allocated toward response to the Haiti outbreak, public health experts may have been able to learn more about the virus earlier, including its pathology and any potential mechanisms to foster immune response.

Yet, at least at a national level here in the United States, funds remain in Congressional limbo. Florida Senator, Marco Rubio, remains one of the few leaders urging funding to fight Zika. Senator Rubio has been particularly vocal about the dire situation in Puerto Rico, which is already suffering financially, and has seen a dramatic reduction in tourism due at least in part to the prevalence of Zika there.

“Many think Zika will not be a problem in Florida,” Dr. Lednicky said. “According to this dismissive camp, many factors, including the American lifestyle and its extensive reliance on air-conditioning, are not conducive to establishment of a long-term Zika transmission cycle. However, there is much we don't understand, yet about how Zika establishes itself in a new niche. It was not too long ago that West Nile virus was dismissed as a ‘virus of animals, not humans,’ yet it wreaked havoc in states like Illinois, where it was assumed the mosquitoes that transmitted the virus couldn't survive the winter months. Florida not only has a suitable environmental landscape and weather [for Zika vector mosquitoes], it has a large population of susceptible inhabitants and animal species [that may] serve as a reservoir for Zika virus. Not too long ago, many were surprised when alligators were found infected with West Nile virus. Who would have thought that? With Zika, will we be surprised as well?”

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.

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