After a three-month delay, the U.S. Senate and House voted on separate bills to address the Zika virus epidemic three weeks ago. But there the bills sit, with no sign of further progress. Now it’s June, it’s hot and the mosquitoes are coming. That should give us cause for concern.
In February, health experts at the National Institutes of Health and the Centers for Disease Control and Prevention asked Congress for money for vaccine development, epidemiologic studies to track the spread of the virus and public health measures at the city and county levels in the Southern states to decrease the risk.
Over the last four months, our U.S. senators and congressmen each has been paid $58,000, more than the total average annual salary of North Carolinians. They also received taxpayer health insurance and retirement contributions and were given support for their staff and travel up to $880,000 during that same time period! Since Sen. Richard Burr and all of our congressmen are up for re-election this year, we might want to tell them to start doing their job. Here’s why.
First noticed in Brazil in May 2015, the Zika virus has infected thousands in 42 countries where there had not been evidence of the virus. Last year, there were an estimated 2,400 babies born with microcephaly (small heads and abnormal brains) in Brazil and 29 infant deaths. By November, Zika had traveled 4,000 miles north to Mexico.
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Although only 1 in 5 people infected will develop symptoms, 1 in 7 babies who are exposed during the first 12 weeks of pregnancy will be born with abnormal brains. One of every thousand infected patients, adults and children, will develop an ascending paralysis, called Guillain Barre syndrome, and some will develop hemorrhagic fever.
The Zika virus is transmitted by two mosquitoes, Aedes aeqypti and Aedes albopictus, which also transmit several other viruses. These viruses are transmitted when a mosquito bites an infected human and then bites another uninfected human. The combination of climate change, adaptation by the mosquitoes, increasing international travel, poor and crowded housing, and inadequate urban infrastructure has led to the epidemic moving north and the current Zika outbreak. Both mosquitoes can be found in North Carolina.
While everyone is focused on the presidential campaign, the Zika epidemic is something we should all pay attention to. Communicable diseases do not discriminate between races, genders, religions or wealth. They are the ultimate in equal opportunity disasters, like Ebola, pandemic influenza and SARS.
As an example of our potential risk from Zika virus, one need only look at two other viruses carried by the same mosquitoes: dengue and chikungunya. Prior to 1981, dengue was not confirmed in Central or South America. Since then, epidemics of dengue have occurred with regularity but only in the Caribbean and South America, not on mainland United States. In 2005, that changed when an outbreak of locally transmitted dengue virus infection occurred in Florida and Texas.
In 2014 chikungunya infection was reported in Florida. Since May 2015, 691 travelers with Zika infection have been diagnosed in all states except Montana, Idaho, North Dakota and South Dakota. With the coming mosquito season, these returning travelers could transmit the virus to others.
Imagine that your wife, daughter, sister or you become pregnant in the next month or two, meaning you are in the first-trimester just as mosquito season starts. Should you move to Canada or live in a bubble? There are proven and safe methods to decrease the risk of a Zika virus epidemic. These methods require full funding of state and county health departments.
Since 2008, accounting for inflation, CDC’s general budget has had an effective 10 percent decrease, despite the U.S. population increasing by 20 million. In North Carolina, excluding Medicaid, the DHHS budget has had an effective 21 percent decrease in funding since 2009, allowing for inflation, while the population has grown 5.1 percent. These budget cuts have a very real effect on our preparedness for disasters.
While we are faced with a new epidemic, Burr and our representatives are busy campaigning for re-election. Let’s let them know that if a single child is born with microcephaly or a single adult dies from Guillain Barre syndrome in the U.S., we’ll hold them accountable.
Dr. Charles van der Horst is emeritus Professor of Medicine at University of North Carolina School of Medicine.