Zika bat­tle gets a boost

$1.1 bil­lion from U.S. eases the bur­den on states and lo­cal­i­ties

Baltimore Sun - - FRONT PAGE - By Mered­ith Cohn

The $1.1 bil­lion al­lo­cated by Congress last week to fight Zika will mean more money for states and lo­cal­i­ties to con­trol and mon­i­tor for the mos­quito-borne virus and for re­searchers to de­velop vac­cines and di­ag­nos­tic tests.

The money, which fed­eral health of­fi­cials said Mon­day would be doled out in com­ing months, will help shore up state and lo­cal gov­ern­ments that have spent largely out of their own bud­gets for ed­u­ca­tional out­reach, mos­quito con­trol and pro­tec­tive agents such as re­pel­lent for preg­nant women, who are con­sid­ered most at risk.

Zika causes the birth de­fect mi­cro­cephaly in the fe­tuses of preg­nant women in­fected by the virus. Ba­bies with the condition are born with small brains and heads and struggle to survive.

It’s also be­lieved to cause prob­lems for some adults, such as vi­sion is­sues and Guil­lain-Barre syn­drome, a ner­vous sys­tem dis­or­der that can lead to tem­po­rary paral­y­sis. Re­searchers also are be­gin­ning to be­lieve that even ba­bies born with­out mi­cro­cephaly may suf­fer prob­lems af­ter birth; some of the fed­eral dol­lars will be used to track some of these chil­dren.

The CDC re­ports that there have been 3,625 cases of Zika in the main­land United States, and an­other 22,000 in U.S. ter­ri­to­ries such as hard-hit Puerto Rico. There have been 808 con­firmed cases in preg­nant women in the con­ti­nen­tal United States,

with 21 ba­bies born with birth de­fects and five preg­nancy losses with birth de­fects.

In Mary­land, there have been 101 cases, in­clud­ing 43 in Bal­ti­more City and the five sur­round­ing coun­ties and 51 in the Mary­land sub­urbs of Wash­ing­ton.

The fed­eral of­fi­cials said Mon­day that the virus con­tin­ues to present a threat even though the weather has turned cooler in much of the coun­try, re­duc­ing mos­quito breed­ing and ac­tiv­ity.

“Zika is the lat­est in un­pre­dicted and unpredictable health threats,” said Dr. Tom Frieden, di­rec­tor of the U.S. Cen­ters for Dis­ease Con­trol and Pre­ven­tion. “The more we learn, the more con­cerned we are.”

As the ex­tent of the threat emerged early this year, the World Health Or­ga­ni­za­tion de­clared Zika a pub­lic health emer­gency. Pres­i­dent Barack Obama re­quested $1.9 bil­lion in emer­gency fund­ing seven months ago, but the re­quest stalled amid par­ti­san bick­er­ing. Congress fi­nally ap­proved $1.1 bil­lion as part of a larger bud­get deal on Sept. 28.

Dur­ing Mon­day’s news con­fer­ence, of­fi­cials from the CDC, the Na­tional In­sti­tutes of Health and the U.S. Depart­ment of Health and Hu­man Ser­vices, ex­pressed frus­tra­tion that law­mak­ers took so long to ap­prove fund­ing.

Frieden said Zika pro­grams across the board will get less fund­ing than ini­tially bud­geted, and that other pub­lic health ini­tia­tives raided to get Zika-re­lated ef­forts off the ground will not be re­paid.

Of­fi­cials at the state Depart­ment of Health and Men­tal Hy­giene said they are await­ing guid­ance on “pos­si­ble amounts, uses and tim­ing of the fund­ing.”

Bal­ti­more City Health Com­mis­sioner Dr. Leana Wen said more fund­ing is needed in places with the most vul­ner­a­ble pop­u­la­tions like Bal­ti­more with its heavy con­cen­tra­tion of peo­ple liv­ing in poverty.

“We hope fund­ing will be tar­geted to ar­eas of great­est need, and that in­cludes Bal­ti­more,” she said.

Peo­ple in these ar­eas are more likely to live near va­cant hous­ing and unat­tended pools of wa­ter, which are prime breed­ing ground for mos­qui­toes, she said. Their houses are less likely to have air con­di­tion­ing or screens to keep mos­qui­toes out. Poor women also face bar­ri­ers to health care, Wen said.

With lit­tle fed­eral fi­nan­cial sup­port, spend­ing on Zika in Mary­land al­ready has topped $1 mil­lion. That in­cludes more Frieden than $500,000 spent by Bal­ti­more City, which has done door-to-door out­reach and put to­gether 9,000 Zika kits for preg­nant women that in­clude re­pel­lent, lar­vi­cide and con­doms be­cause Zika can also be sex­u­ally trans­mit­ted.

The state spent $130,000 on its own kits, and $20,000 on ed­u­ca­tional sem­i­nars and mos­quito con­trol. With most coun­ties re­ly­ing on the state agri­cul­ture depart­ment to spray for mos­qui­toes, the state boosted the agri­cul­ture depart­ment’s an­nual $2.7 mil­lion mos­quito con­trol bud­get by $420,000.

In the ab­sence of for­mal fund­ing, fed­eral health of­fi­cials bor­rowed funds from other pro­grams, like those for Ebola, to get vac­cine tri­als un­der­way.

The Univer­sity of Mary­land is one of three sites that have be­gun test­ing a vac­cine de­vel­oped at the Na­tional In­sti­tutes of Health on hu­mans. The new fund­ing will en­sure that if the trial is suc­cess­ful and shows the vac­cine is safe and in­duces an im­mune re­sponse, it will go through more ad­vanced tri­als in more heav­ily af­fected coun­tries.

There are a to­tal of nine vac­cines in de­vel­op­ment through govern­ment labs, uni­ver­si­ties and pri­vate biotech firms.

There also has been some fed­eral spend­ing on test­ing for Zika and as­sis­tance to Puerto Rico and Florida, which is the only state with lo­cally trans­mit­ted in­fec­tions.

Christo­pher Gar­rett, a spokesman for the state health depart­ment, said the agency still must be pre­pared be­cause Zika is trans­mit­ted not just by mos­quito bite but through sex­ual trans­mis­sion, and lo­cally ac­quired cases re­main pos­si­ble.

The CDC widened its guid­ance last week for men who have been ex­posed to the Zika virus but have no symp­toms. Of­fi­cials now say cou­ples should wait six months be­fore try­ing to con­ceive if the man has been ex­posed to Zika. Its pre­vi­ous guid­ance rec­om­mended wait­ing two months. The agency also con­tin­ues to ex­pand travel warn­ings to more heav­ily af­fected coun­tries.

Most lo­cal­i­ties have spent their own money on pre­ven­tion. So far, the city and coun­ties have re­ceived only about $15,000 each in fed­eral fund­ing through the state, Wen said.

To pay for its re­sponse, she said, the city di­verted re­sources from other “key pri­or­i­ties,” in­clud­ing a re­duc­tion for opi­oidrelated pro­grams at a time when over­dose deaths are at records highs.

Of the 43 cases of Zika, 12 have been in Bal­ti­more, Wen said. The rest are spread among the five sur­round­ing coun­ties.

“We hope fund­ing will be tar­geted to ar­eas of great­est need.”

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