I’ve been following the Zika story relatively closely and recently learned that five new cases of Zika have been diagnosed in Miami Beach. These transmissions were not the result of travel or sexual transmission. They were transmitted by mosquitos in Miami Beach to people in Miami Beach.
Zika usually doesn’t harm adults but it affects unborn babies in a profound way. Zika-caused microcephaly is truly terrifying. Even in adults, though, Zika can cause Guillain-Barré Syndrome, which is sometimes fatal. At least one adult in Puerto Rico has died from Zika.
Zika is spread by the Aedes albopictus and Aedes aegypti mosquitos. CDC maps show that these mosquitos have range as far north as New Hampshire, and as far west as California. If we were to overlay these maps on maps that show US population density we would show that most of the US population lives in the same places the Zika-carrying mosquitos do.
These maps are of the continental United States. They do not include Puerto Rico, where health officials already estimate that thousands of pregnant women will become infected with Zika and that hundreds of babies will be born with microcephaly.
Initial symptoms of Zika are mild, and a large percentage of infections are asymptomatic. Tests for detecting Zika are expensive and complicated, meaning that most people who do have the mild symptoms associated with Zika but who aren’t considered “high risk” probably never get tested for the virus.
This means that Zika has probably already traveled further and infected more people in the United States than has been reported.
The CDC has already said as much:
Dr. Thomas R. Frieden, the C.D.C. director, warned at a news briefing on Friday that more cases of local Zika transmission are likely to emerge in the other parts of the county. The agency he leads said in a statement that because so many people infected with Zika have no symptoms, because the virus can incubate for two weeks and because diagnosis of cases can take several weeks, “it is possible that other neighborhoods in Miami-Dade County have active Zika transmission that is not yet apparent.”
It seems as if the CDC would maybe like to issue a more sweeping health warning, but finds it politically and legally difficult to do so.
The New York Times writes, asking us to read between the lines:
“What we’re doing is stepping back and saying there have been now multiple areas of individual transmission,” he said. “It’s a large county. There are more than two million people there, more than 20,000 pregnant women. We would always err on the side of caution.”
The C.D.C. generally must defer to state officials to decide where to set the boundaries around an area of potential disease transmission and what travel warnings to issue, federal officials and health experts said.
“The state has authority within its borders and it takes advice and counsel from the C.D.C.,” said Dr. William Schaffner, head of preventive medicine at Vanderbilt University’s medical school.
Incredibly, the CDC didn’t detect the Florida outbreak. It was actually discovered by Taiwanese public health officials:
The realization that Miami Beach was a zone of Zika transmission was triggered by a news release from Taiwan that C.D.C. officials noticed on Wednesday, Dr. Petersen said. Taiwan’s Center for Disease Control reported that a 44-year-old woman who visited Miami for business in early August, sought medical treatment for a rash on her legs and abdomen. The woman, who is not pregnant, tested positive for Zika.
“We tried repeatedly to get in touch with Taiwan the minute we heard about this,” Dr. Petersen said. With the time difference, C.D.C. officials were not able to talk to Taiwanese officials until 6 a.m. Thursday. What they learned, he said, “ provided pretty strong evidence that these other people who had gone to multiple places” including Miami Beach, had probably been infected there.
It’s likely that Zika has already spread to more parts of the continental United States than the US government is saying. Public health warnings from the CDC are being controlled at least in part by governors who want to preserve their tourist economies.
The Zika threat is severe, and vaccines are still a long way off. It’s likely that the American public health system will be able to prevent many microcephalous births through aggressive prenatal scans and early termination of affected pregnancies. But the impact on American birth rates, happiness and economics could be severe.
Congress has allowed politics to interfere with federal funding for the fight against Zika, and this must stop immediately. The parties need to come together and approve money for the fight against Zika, and must do it immediately.
The Zika epidemic must get no additional health from American government dysfunction. It’s time for competent, non-partisan leadership. Harry Reid has called for Congress to return from recess to approve the funds. This should be done today.
Congress should also act to ensure that CDC is free to combat the virus in the way it sees fit: the governor of Florida should not be dictating the geographic area of the CDC’s travel warnings. Politics and protection of tourist economies have no place in the fight against Zika.