Timeline of Zika in the US: the dynamics between Public Health and Politics

Zika has arrived in the United States and is spreading via homegrown mosquitoes. The Centers for Disease Control (CDC) has confirmed 14 cases in the Miami area that were almost certainly contracted through the bite of locally infected mosquitoes, and the number is climbing fast. Nationally, CDC reports more than 1,600 cases of imported Zika in 46 states and D.C., including more than 400 pregnant infected women. The situation is even worse in Puerto Rico, a U.S. territory that is failing to control an exploding epidemic. Thousands of people — including up to 50 pregnant women — are becoming infected there each day.

Zika is a significant women’s health issue. While primarily transmitted by mosquitoes, the virus can also be transmitted sexually or perinatally, leading to birth defects, such as microcephaly. Men can carry the virus for more than two months after an infection, thus ensuring sexual transmission as well as mosquito-borne disease. Center for American Progress (CAP) has estimated that more than 2 million pregnant women in the United States are potentially at risk of infection with the Zika virus this summer and early fall. Currently, there are more than 600 pregnant women being monitored for the Zika virus, and seven infants have been born with microcephaly in the United States and its territories.

It is now critical to ensure access to reproductive and maternal health care, both to fight the Zika outbreak and to curb the effect the virus can have on women. Moreover, the most effective responses will meet the needs of those who will be most heavily impacted, particularly low-income pregnant women and women of reproductive age. They have low access to health services including family planning (FP), and have high unmet needs for FP.

Overall, US needs to focus on two things to fight Zika: First, provide preventive and healthcare services in compliance to the latest updated CDC guidelines on Zika to: (1) those women who want to have babies/ planning to have babies, or are pregnant and in the process of having babies, and (2) those women who want to prevent pregnancies (FP services) or are pregnant but do not want to have a baby (safe abortion services); Second, put pressure and call on the congress to pass the Emergency Zika funding of $1.9 billion urgently.

Below is the most updated timeline of the Zika virus in the US.

22 February 2016:

- President Obama submitted a request to Congress for $1.9 billion in emergency funding to support the full range of activities needed to prevent, detect, and respond to the Zika virus and its serious associated health effects. Out of the total — $1.48 billion was allocated for the U.S. Department of Health and Human Services, $828 million for CDC surveillance activities and $200 million for vaccine research and diagnostic development and procurement.

6 April 2016:

- In an effort to break the two-month deadlock over funding to fight the encroaching Zika virus, Obama administration officials announced they would transfer $589 million Ebola fund to the Zika battle.

29 April 2016:

- the CDC confirmed the first Zika-related death in the US occurred in February 2016. Zika first appeared in Puerto Rico in December 2015.

28 June 2016:

- The Senate blocked a plan to spend $1.1. billion to fight the Zika virus, as Democrats objected to added provisions that would limit funding for birth control, allow pesticide spraying near water sources, and raise the confederate flag.

14 July 2016:

-The Congress left for a seven-week recess without approving any of the $1.9 billion requested by President Barack Obama in February to develop a vaccine and control the mosquitoes that carry the virus.

29 July 2016:

- the CDC confirmed 4 cases of locally transmitted cases of Zika infection in Miami, Florida, the first locally transmitted cases confirmed in the mainland US.

1 August 2016:

- Florida Department of Health (DOH) identified 10 additional people in Florida with the Zika virus who likely contracted it through a mosquito bite. This brings the total number of people with locally transmitted Zika to 14, and 4,708 cases in U.S. territories.

- New cases were found by door-to-door surveys of 200 people in their homes and businesses, and they were identified by urine and blood samples that tested positive for the virus or an antibody.

- CDC issued a travel advisory to Miami/Florida.

2 August 2016:

- Federal health officials, scrambling to fund efforts to combat the spread of the Zika virus in the United States, have provided more stopgap money to various locales while calls grew for Congress to cut short its recess and act. The Centers for Disease Control and Prevention said it provided more than $16 million to 35 states and five territories to help detect any cases of microcephaly.

- The Obama administration has now spent about $201 million out of the $374 million it repurposed in April to fight Zika — leaving about half of its funding still available. The CDC, specifically, has also spent about half of its $222 million in available funding.

3 August 2016:

- Sens. Rubio, Kaine called on Congress to Return to D.C. to pass Zika funding legislation; this came a day after Sen. Bill Nelson (D-Fla.) sent a letter to Majority Leader Mitch McConnell (R-Ky.) urging him to pass the Senate’s $1.1 billion deal during a “pro forma” session — Republicans quickly dismissed his proposal.

- Department of Health and Human Services reported of current funding to be depleted by end of September: HHS shifted $374 million from other programs to fight Zika in the U.S., with $222 million allocated to the Centers for Disease Control for domestic response including front-line assistance to states and localities. Of that, nearly $100 million will have been provided by week’s end, and resources will be virtually exhausted by the end of the fiscal year on Sept. 30.

- NIH began first clinical trial of experimental Zika vaccine: The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health federal research agency, said its early-stage clinical trial will involve at least 80 healthy volunteers ages 18 to 35 at three study sites. It said the trial will evaluate the experimental DNA-based vaccine’s safety and ability to elicit an immune system response.

4 August 2016:

- President Barack Obama called on Congress to go back to work and pass the funding he has sought since February to combat the disease now spreading in Florida.

- News have come forth on More than 40 members of the U.S. military having contracted the Zika virus this year in countries where it is present.

- As the Zika virus spreads in Florida, Gov. Rick Scott has toured the state, talked up his administration’s commitment to fighting the mosquito-borne ailment and frequently criticized Congress and President Obama for not spending enough to help out. But Scott is far less eager to talk about his own record of cutting mosquito-control programs over the years, including the elimination of a state-funded pesticide-testing facility that was once known as “the mosquito lab.”

- As concerns rise about the spread of Zika in the U.S., regulators and blood banks are moving to protect the safety of the blood supply.

- Aerial spraying of insecticide began in the one-mile-square area of Miami where mosquitoes have infected people with the Zika virus.

- Three experimental Zika vaccines protected monkeys against infection from the virus, an encouraging sign as research moves into studies in people. The vaccines assessed by researchers from the Walter Reed Army Institute of Research, Harvard Medical School and elsewhere use three different methods to generate an immune response in patients.

9 August 2016:
 
 -A baby girl has died in Harris County from complications related to the Zika virus which is the first known fatality in Texas linked to the virus. It is the second Zika-related death in the continental United States after an elderly man in Utah died in June.
 
-Florida health authorities have found four more people who likely contracted Zika through mosquito bites in the Miami neighborhood where an outbreak began
 
 -U.S. Democratic presidential candidate Hillary Clinton urged federal lawmakers currently on summer recess back into session to pass a crucial funding bill to combat the Zika virus as she visited a health clinic at the heart of a local outbreak in Miami.
 
 -Americans are still not worried about Zika, poll finds. Sixty-five percent of Americans say they are “not too” or “not at all” worried about being infected with Zika or about having an immediate family member become infected, which is hardly changed from 67 percent in June. Just over one-third of the public, 35 percent, is at least somewhat worried, though only 12 percent say they are “very worried” about infection.

(This timeline will be updated as more news comes by on Zika response in the US)