Stopping Zika’s March Into U.S. and Puerto Rico

ZikaLike a hurricane watch that shows a storm headed for Puerto Rico or the U.S. mainland, government officials are scrambling to communicate, trying to stop as best they can, and prepare for the aftermath of Zika’s steady march (or mosquito-borne flight) into the country.

According to the U.S. Centers for Disease Control and Prevention (CDC), more than 500 people in the country contracted the Zika virus so far this year; 53 of them were pregnant women. Many of those people traveled to an area with a Zika epidemic and brought it back. However, in Puerto Rico, the illness is spreading locally and, by some estimates, could infect almost 1 million people on the island this year.

While is has been around since being discovered in Uganda in 1947, the Zika virus was considered to be mild and flu-like – until last year – and transmitted only by mosquitoes. For the first time, the illness hit major population centers and it soon became apparent that it poses potentially devastating threats to unborn babies (in the form of birth defects such as microcephaly) and is potentially a cause of Guillain-Barre, which can lead to paralysis, in those who contract the virus.

CDC director Dr. Tom Frieden recently said, “We are learning more about Zika every day. The link with microcephaly and other possibly serious birth defects is growing stronger every day.” He indicated that the Guillain-Barre syndrome is expected to be proven soon. In addition, public health officials now know that the disease can be transmitted during sex and via blood donations (for which there is no test yet to detect the virus’ presence, but two companies are developing tests that could be employed in a few months).

Those new findings have caused officials to recommend that pregnant women use condoms during sex to avoid possibly getting the illness, which is often not recognized as more than a cold in some patients. They have caused organizations to reject blood donations from people who traveled to the regions with Zika outbreaks and forced areas like Puerto Rico to import blood donated from other areas.

Based on the experience with the Zika epidemic so far in the Americas, one out of every 100 pregnant women who becomes infected with the virus during their first trimester will give birth to a baby with the microcephaly birth defect. Additionally, the disease has also led to an increase in miscarriages.

In Puerto Rico, however, the situation is “of great concern,” noted Frieden, given the climate which is ripe for mosquitoes. “Puerto Rico is on the frontline of the battle against Zika,” he said, acknowledging, “And it’s an uphill battle.”

Nearly 100 women a day become pregnant on the island. Given the experience in South America, that translates to more than 350 babies being borne with severe birth defects, if they survive, if Puerto Rico cannot protect the women from getting infected.

President Obama has asked for $1.9 billion to fight Zika, including $225 million for the CDC, but the package is stalled in Congress. While awaiting greater funding, the CDC efforts at stopping Zika’s march into Puerto Rico and other parts of the U.S. have involved bringing in additional staff to their lab on Puerto Rico. and equipment to test blood, once the means being tested now are approved. They also arranged for the crates of blood from other parts of the U.S.

For Puerto Rico, with an economy in dire straits, a full-scale epidemic will be devastating to the tourist industry, which features many vacation hot spots and hosts countless cruise ships all summer. To try to protect the residents, trucks are spraying areas with insecticide. Schools are getting screens on windows to protect children during the day.

Given the experience in Brazil, where more than 5,100 babies have been born with birth defects in the past six to eight months, the Puerto Rican officials are heavily targeting pregnant woman to educate about mosquito repellents like Deet and ways to protect themselves. However, it could be another year before it is clear whether this March’s efforts to stop Zika’s spread in Puerto Rico and thwart it from becoming a health crisis on the mainland are effective.

Written and Edited by Dyanne Weiss

New York Times: Puerto Rico Braces for Its Own Zika Epidemic
Reuters: WHO backs trials of bacteria, genetic modification to fight Zika mosquitoes
U.S. Centers for Disease Control and Prevention (CDC)
U.S. News and World Report: U.S. Takes to Air to Fight Zika

Photo courtesy of CDC

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