CDC Director Confirms Zika Will Become Endemic in the US

If you thought the Zika virus crisis was going away with the end of the summer mosquito season, think again: one of the nation’s top public health officials believes the disease is destined to spread across the United States in the coming months.

Speaking at the CityLab 2016 conference in Miami, ground zero for the mosquito-borne virus in North America, Centers for Disease Control and Prevention (CDC) Director Thomas Frieden, MD, MPH, said delays in federal funding resulted in federal, state, and local agencies being slow to respond to Zika, after it first emerged in Brazil and the Caribbean in 2014. Because of the delay, he told the audience, it is likely additional case clusters will emerge as a result of people sustaining bites via “local” mosquitoes carrying the virus or through sexual contact with someone who is infected. To date, Alaska is the only state without any confirmed Zika cases.

“Zika and other diseases spread by [mosquitoes] are really not controllable with current technologies,” Dr. Frieden said, according to a report in USA Today. “We will see [Zika] become endemic in the hemisphere.”

The CDC director also noted that his agency has had to cut monies allocated to several other initiatives—such as HIV testing and education—to combat the Zika virus, particularly once localized cases emerged in south Florida. The CDC has an annual budget of $14 billion, but Congress has limited emergency funding for the agency to $2.5 million, and it is currently required to request Congressional approval for additional funding prior to any public health emergency response.

“We had to take money from every state in the country and give it to the states that needed it more for Zika,” he explained. “We do the best we can with the cards we’re dealt. But this shows how really important it is that there is emergency funding.”

The CDC announced on October 24^th that it has already made approximately $70 million in supplemental funding available to states, cities, and territories to support anti-Zika initiatives. The funding, which will be distributed through the agency’s Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement, will be used to support “epidemiologic surveillance and investigation, improve[ed] mosquito control and monitoring, and [additional] laboratory capacity,” the CDC said. Distribution will be based on “Zika disease burden, current laboratory and mosquito surveillance and control capacity, the presence of the Zika virus vector (Aedes aegypti and Aedes albopictus mosquitoes), and local Zika virus transmission,” among other factors, according to a CDC statement.

Fortunately, Dr. Frieden’s news regarding Zika wasn’t all bad. Although a viable vaccine is likely years away, human trials for a candidate vaccine started on October 25^th at the University of Maryland School of Medicine in Baltimore. In addition, biotech firm Heat Biologics recently entered into an agreement with the University of Miami’s Miller School of Medicine for the license and development of its gp96 biologic therapies platform, used primarily to treat cancer, for a Zika vaccine. The laboratory of Natasa Strbo, MD, DSc, at Miller, which will be overseeing the Zika project, in earlier research found that a gp96-based vaccine for SIV (the primate equivalent of HIV) “induces a dramatic antigen-specific immune response in the mucous membranes,” according to a report in EconoTimes.

“Miami has become the epicenter for Zika transmission in the US,” Dr. Strbo told EconoTimes. “In [our study], a gp96-based vaccine effectively protected primates from acquiring the SIV virus and induced T-cells to infiltrate cancer tumors after human vaccination. This led us to hypothesize that a gp96 vaccine might stimulate a similar virus-specific response in the placenta of Zika-infected women that could clear the virus and protect the fetus.”

In a commentary published in the September 29 issue of The New England Journal of Medicine, authors Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID); Hilary D. Marston, MD, of NIAID; Nicole Lurie, MD, MSPH, assistant secretary for Preparedness and Response, US Department of Health and Human Services; and Luciana L. Borio, MD, acting chief scientist, US Food and Drug Administration, described the challenges associated with vaccinating pregnant women, arguably those affected most by the Zika virus and its complications, and endorsed an approach that entails vaccinating women of childbearing age and their sexual partners.

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.