The first known case of sexual transmission of Zika from an asymptomatic man to his partner was reported this week. Although he was symptom-free, he had recently been in the Dominican Republic, an area where Zika is known to be present. He acknowledged that he had been bitten by mosquitoes. The significance of this case cannot be underestimated as Zika continues to spread in the Americas. According to a story on CNN, Dr. John Brooks, a medical epidemiologist with the CDC advised that,

“Pregnant couples need to defer unprotected sexual contact for the entire pregnancy, even if the exposed partner never develops symptoms of Zika. A few months of precautions can prevent devastating lifelong defects for the developing fetus.”

The problem is we don’t know where Zika is going to pop up next. According to the CDC, local mosquito-borne Zika virus transmission has been reported in two areas of Miami, FL as well as three U.S. territories (Puerto Rico, American Samoa, and the U.S. Virgin Islands). Travel-associated cases, 2487 of them, have now been reported in every single state except Wyoming. It is noteworthy that 22 of these cases were sexually transmitted.

There are now concerns that Zika could spread to other states in the Gulf Region, particularly Louisiana because we can anticipate areas of standing water, the breeding ground for mosquitoes, due to the floods. Further exacerbating the problem is that global warming has extended mosquito season significantly in some areas. It is now 337 days long in Miami—up from 317. Ten cities, including Baltimore, St. Louis, and Pittsburgh, have seen these conditions extend by more than a month, some as far north as Portland, Maine, and Minneapolis.

It isn’t just mosquitoes and sexual transmission that we have to worry about. A few days ago, the Food and Drug Administration (FDA) recommended that all blood donations in the United States and its territories be tested for the Zika virus.

When the epidemic first broke out, we thought that developing fetuses were most at risk for bad outcomes from this infection. Most infected people were believed to be asymptomatic or mildly symptomatic with rash, red eyes, fever, and malaise. It was believed they would have no long-term consequences, although a small percent developed Guillain-Barre Syndrome, a neurologic disorder that temporarily causes muscle weakness and even paralysis. Now, however, a study in mice suggests that adults may also be at risk for brain damage related to Zika infection.

 

Playing politics with Zika

When we put all of these things together, it is clear that the anemic response to this infection from Congress is inexcusable. They were adequately warned of the potential seriousness of Zika, but they played games with efforts to fund a vigorous response before going on a 7-week summer break without passing a funding bill. Shameful!

The U.S. is facing what could become an epidemic of Zika-related conditions—the most serious of which is severe brain damage in newborns. We need a vigorous, multipronged, national effort to prevent that from happening and we need it NOW.

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