Zika: Pandemic in Progress

Anthony Fauci, MD, Director of NIH’s National Institute of Allergy and Infectious Diseases (NIAID) www.niaid.nih.gov updated a group of reporters on the progress being made to deal with the Zika Virus at a briefing held at the National Press Club in Washington D.C. on August 11, 2016.

Marilyn Serafini of the Alliance for Health Reform www.allhealth.org and Bob Lott of Health Affairs www.healthaffairs.org moderated the discussion.

As Dr. Fauci explained, Zika is closely related to dengue, yellow fever, Japanese encephalitis, and West Nile viruses and transmitted to humans primarily by the Aedes mosquito species. The virus was first isolated from a monkey in the Zika forest of Uganda in 1947 and the first human cases were reported in Nigeria in 1952.

He talked further about the history of the virus and how the Zika virus spread across the Pacific from 1947 to 2016. First the Zika virus hit French Polynesia in the South Pacific in 2013. Next, the virus was able to work its way across the Pacific to hit Brazil in 2015 resulting in a marked increase in microcephaly cases in Brazil.

Suspected female-to-male sexual transmission of the virus occurred in New York City in 2016. As of August 2016, 55 countries and territories with 46 in the Americas/Caribbean have been affected.

As reported, symptoms of the Zika Virus infection are relatively mild with four in five individuals asymptomatic. The incubation period is 3-12 days with mild symptoms lasting 2 to 7 days.

Zika virus disease in the U.S and the District of Columbia in 2015-2016 show that there were 1,825 cases related to travel and 5,548 cases reported in the U.S Territories. In the same period in the U.S and District of Columbia, 479 pregnancies resulted plus 493 pregnancies resulted in U.S. territories.

As Dr. Fauci announced, NIAID has launched a Phase 1 clinical trial for a vaccine candidate intended to prevent the Zika virus. At least 80 healthy volunteers ages 18-35 at three study sites are expected to participate in the trial with initial results expected by January 2017. Dr. Fauci said, “Although it will take some time before a vaccine is commercially available, the launch of this study is an important step forward.”

Rick Bright, Acting Director of the Influenza Division in the Biomedical Advancement Research and Development Authority (BARDA) www.phe.gov/barda within the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR), is leading BARDA’s Zika medical products development program.

He said, “The goal is to prevent Zika virus infection through new vaccines and detect acute and previous Zika virus infections through new rapid diagnostics. Also, BARDA is working to ensure that blood supplies are safe from the virus through the use of screening tests for donated blood and for virus inactivation in blood products.”

Two pathogen reduction device technologies are being researched that may help reduce the risk of transmitting disease through blood product transfusions including diseases related to the Zika virus. Contract support for the development of the technologies is being provided through the BARDA program.

Kelley Murphy, Program Director, Health Division, for the National Governors Association’s (NGA) Center for Best Practices www.nga.org/cms/center, reports that Governors have focused on implementing phased, jurisdictional, risk-based Zika plans. Their goal is to develop effective strategies related to communicating to the population, to update surveillance abilities, plus do laboratory testing, mosquito control, provide for blood safety, and reach out to pregnant women.

NGA is actively involved in CDC’s www.cdc.gov Zika Action Partnership Network and is working with other organizations to increase coordination and collaboration. Importantly, NGA has launched a Zika web page to provide a custom map made for states to track Zika cases.

“Resources are needed from the federal level to help at the local level”, said LaMar Hasbrouck, Executive Director for the National Association of County and City Health Officials (NACCHO) http://naccho.org. He is disappointed because so far Congress has yet to provide additional funding to respond to the Zika.

The briefing was a joint effort by the Alliance for Health Reform, Health Affairs, and the Jayne Koskinas Ted Giovanis Foundation for Health and Policy http://jktfoundation.org.