Over the past week, leading health officials warned that they expect cases of local Zika virus transmission to emerge in the United States. The virus is currently spreading throughout Latin America and is responsible for a sharp spike in birth defects and neurological disorders. So far, cases within the US have been limited to people who contracted the virus abroad, and their sexual partners.
On Sunday, Dr. Anthony Fauci who works for the National Institutes of Health, told CBS’s “Face the Nation” that with “infections that are quite similar to Zika, like dengue and chikungunya, which are transmitted by exactly the same mosquito and have been in the Caribbean, South America for awhile, we have seen in the past little clusters of local transmitted cases within the country.” He added that there was no cause for alarm because “in the past, we have successfully prevented [outbreaks] from becoming sustained and disseminated.”
In a New York Times op-ed piece, the dean of the National School of Tropical Medicine at Baylor College warned that without a coordinated response the Zika virus could sweep through the Gulf Coast, creating “a catastrophe to rival Hurricane Katrina.” He noted that the same mosquitos, poverty, and overcrowding that allowed Zika to infect over a million Brazilians in a couple of years exist throughout the Gulf region.
The Zika virus is spread primarily by the Aedes Aegypti mosquito, which is well adapted to urban environments. It is capable of breeding with just small amounts of stagnant water like that found in discarded tires, plastic containers, or drainage ditches. Crowded housing conditions with torn or insufficient screens then allow the mosquito to spread the disease widely.
Secondarily, the Zika virus can be sexually transmitted, which can extend an outbreak beyond the extent of the Aegypti mosquito.
Fundamentally, Zika is a disease of poverty. Basic sanitation and water infrastructure significantly reduce mosquito populations, and the cost of mosquito netting to prevent bites averages less than 50 cents a year per person.
The US territory of Puerto Rico, where 45 percent of the population is below the poverty line, demonstrates this. As of mid-April there were four cases of Zika contracted abroad and 471 cases transmitted locally by mosquito in Puerto Rico, according to the Centers for Disease Control (CDC). In comparison, there were no local mosquito transmissions in the states and 358 travel-associated cases.
Stephen Waterman, a CDC researcher, told NBC News that 15 to 20 percent of Puerto Ricans are at risk of contracting the virus, or nearly half a million people. A major outbreak would hit the island particularly hard due to budget cuts to health care resulting from its $72 billion debt crisis. San Jorge Children’s Hospital is the largest on the island, and has had to close wings, leave 100 staff positions unfilled and cut pay when the territory failed to make a $250 million payment to hospitals last year.
Funding to combat the disease and prepare for potential outbreaks is entirely lacking. The CDC’s request for just under $2 billion in funding from February is still being negotiated behind closed doors in the Senate. The amount requested is slightly more than the daily discretionary spending of the Department of Defense.
In the meantime, the CDC is relying on $589 million previously allocated to fighting the Ebola epidemic that killed over 11,000 in West Africa, for fighting the Zika virus.
The full impact of the current Zika epidemic is impossible to measure. The extent of the Zika virus in Latin America can only be roughly estimated because there are no simple tests for the presence of the virus, and the majority of people who contract the disease show no symptoms. The epidemic within Brazil was only discovered at least a year after it began, due to the sharp spike in microcephaly cases.
Worldwide, over 2 billion people live in areas that are conducive to Zika transmission.
Moreover, the long term effects of the Zika virus are poorly understood. Some of the microcephaly cases caused by Zika meet the criteria of an exceptionally rare condition known as fetal brain disruption sequence, where the fetal brain first develops and then collapses. It is a much more severe condition than the brain failing to fully develop in more traditional cases of microcephaly.
In addition to birth defects, Zika is associated with neurological disorders in adult patients, particularly Guillain-Barré syndrome, an autoimmune nervous disorder, as well as inflammation of the brain or spinal cord. Before the Zika outbreak, these conditions were usually temporary, but a recent study of six patients in Recife, Brazil showed five had “sustained motor dysfunction,” one had cognitive decline and one had vision problems after they were discharged.
Although the Zika virus was first isolated in Uganda in 1947, little is known about it. There is no scientific consensus on whether the neurological disorders caused by the disease in the current outbreak are new. They could be the result of a new strain of the virus evolving, or it could have been a longstanding feature of Zika fever that went unnoticed until the massive outbreak in Brazil made the connection obvious.
It is an indictment of the capitalist system that diseases like Zika can be known for 70 years and yet not studied because there is no profit to be made. Without a fundamental change in social conditions, including universal health care to catch new diseases quickly and medical research based on social need instead of drug companies’ profits, epidemics like Zika and Ebola will continue to emerge.