Local Zika Infections in Puerto Rico Prompt HHS and CDC to Take Initiative

Fear of a Zika epidemic in Puerto Rico lead the US Department of Health and Human Services (HHS) to initiate the transportation of “safe blood” to the island on March 5, 2016, two days before the Centers for Disease Control and Prevention (CDC) Director, Tom Frieden, MD, MPH, arrived there to evaluate the CDC’s support for Zika response and inform residents of prevention methods.

The Situation in Puerto Rico

On December 31, 2015, the first locally-acquired Zika virus infection was reported to the CDC, which then issued a travel notice cautioning travelers to take the necessary preventive steps to avoid Zika infection. Since then, cases of Zika infection have been doubling weekly on the island, reports Reuters.

On March 7, 2016, Josh Earnest, White House Press Secretary, addressed the current Zika situation in Puerto Rico, stating “Spread of the virus in Puerto Rico has been a cause for concern. As of March 4… 160 cases of Zika virus infections in Puerto Rico have been reported to the CDC, and based on the previous history of diseases [chikungunya and dengue] spread by the same type of mosquito, thousands of Puerto Ricans could become infected this year alone.”

Although most individuals infected with Zika do not present with symptoms, Zika may be linked to several conditions in pregnant women and newborns.

Blood Screening and Donations

Although there has been a development in rapid Zika virus testing, there has yet to be any progress in blood screening for Zika, which heightens the risk of infection through blood transfusion. To ensure the safety of the island’s blood supplies, the HHS has commenced the collection of blood donations from areas in the continental US where there is no active transmission of the Zika virus. The blood shipments are currently being supplied by the American Red Cross, the Blood Center of America, and America’s Blood Centers, to Puerto Rican blood collection centers for distribution.

CDC Involvement in Puerto Rico

To reinforce the urgency of the matter, Reuters reports that Dr. Friedan met with CDC staff stationed in Puerto Rico, as well as government officials, such as PR’s Governor, Alejandro Javier Garcia Padilla, to discuss infection prevention strategies. One of the pressing issues that Dr. Friedan discussed was the shortage of window screens and air condition systems present in Puerto Rican homes, combined with the abundance of the Aedes aegypti mosquitos in the area. His main concern was preventing infection in pregnant women, to whom CDC researchers have provided Zika prevention kits.

Commenting on the importance of protecting pregnant women from contracting the Zika virus, Dr. Friedan explained to Reuters, "Until a few months ago, no one had any idea that Zika could cause birth defects."

Prevention of Zika Virus

Since no vaccine exists for Zika, the CDC recommends that anyone living in or traveling to a Zika-infected region takes the following preventive steps:

• Avoid travel to infected regions
• Avoid mosquito bites Wear long sleeved shirts and long pants Stay in closed places with air conditioning Place screens on all open windows and doors Use mosquito bed nets Use insect repellants
• Do not engage in unprotected intercourse with an infected individual
• If infected, avoid contact with mosquitos
• Clear the vicinity of your home from open water containers

The Future of Zika Prevention Measures in Puerto Rico

Dengue Branch Scientists in Puerto Rico are actively researching vector control measures as well as conducting blood tests on samples delivered daily to their labs. This has led to the CDC’s development of a test that can differentiate between which of the three flavoviruses, transmitted by Aedes aegypti mosquitos, a blood sample is infected with. The CDC is actively monitoring outbreaks on the island, as well as researching optimum prevention methods through Zika education campaigns. Furthermore, HHS confirms that the FDA, the Office of the Assistant Secretary for Preparedness and Response/Biomedical Advanced Research and Development Authority and the CDC are working to produce a blood donor screening test for Zika, since it is a top priority at the moment.