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U.S. Public Health Response to Zika - House ECC

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Examining the U.S. Public Health Response to the Zika Virus

Wednesday, March 2, 2016 - 10:15am
Location: 
2322 Rayburn
Examining the U.S. Public Health Response to the Zika Virus
Subcommittees: 

Witnesses

Dr. Luciana Borio 
Assistant Commissioner for Counterterrorism Policy, U.S. Food and Drug Administration

Mr. Joseph M. Conlon 
Technical Advisor, American Mosquito Control Association

Dr. Anthony Fauci 
Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health

Dr. Thomas R. Frieden 
Director, Centers for Disease Control and Prevention

Mr. Lawrence O. Gostin 
Faculty Director, O'Neill Institute for National and Global Health Law, Georgetown University Law Center

Dr. Peter J. Hotez 
Dean, National School of Tropical Medicine, Texas Children's Hospital

Dr. Nicole Lurie 
Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services

Dr. Timothy M. Persons 
Chief Scientist, U.S. Government Accountability Office

Dr. Jeanne S. Sheffield 
Director of the Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine

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Health officials urge lawmakers to fund Zika response

By Steven Ross Johnson  | March 2, 2016
The nation's top health officials told lawmakers on Wednesday that efforts to combat the spread of Zika would be severely hindered if they reject President Barack Obama's request for $1.9 billion in emergency funding. They also said any diversion of Ebola funds would set back work in West Africa. 

Speaking before members of a House oversight subcommittee, Centers for Disease Control and Prevention Director Dr. Tom Frieden said the Ebola epidemic was not over in the countries most affected by the two-year outbreak. A total of more than 28,000 cases have been reported in Liberia, Guinea and Sierra Leone since the beginning of the epidemic,according the World Health Organization, resulting in more than 11,000 deaths.

Frieden said the CDC currently has 84 staffers in West Africa. He said labs there last month tested as many as 10,000 samples for signs of the Ebola. 

In 2014, Congress approved more than $5 billion in emergency funding as part of a five-year plan to combat Ebola and improve preparedness for future infectious disease threats. He said resources have already been diverted from other diseases to address the Zika outbreak.

“We're already drastically scaling back the work we're doing on other diseases,” Frieden told committee members. “Without the supplemental funding, we won't be able to most effectively reduce the threat against pregnant women by learning more and doing more to protect them.”

Zika has been linked to a rise in reported cases of microcephaly, a neurological condition that's linked to babies being born with abnormally small heads. More than 4,600 cases of microcephaly have been reported in Brazil since the start of the Zika outbreak there last year.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases told lawmakers the vast majority of the $238 million meant to fund an Ebola vaccine has been spent toward those efforts. He said the estimated $9 million that remains will be used to continue testing the vaccine, which is in the late-stage trial phase. 

“Quite frankly, we don't have any Ebola money to switch over,” Fauci said. 

Fauci said the government is partnering with pharmaceutical firms to develop and produce a Zika vaccine. He expected a candidate to enter the first phase of clinical trials this fall. He said a lack of funding toward Zika could result in those efforts being delayed.

He said drug companies would likely pull out of efforts to produce a vaccine if there were no assurances that funding was available to finance the effort. “If it turns out we don't get the supplement, we will be viewed (by the drug companies) as an unreliable partner,” Fauci said.

Last week, the CDC reported it has tested 257 pregnant women for Zika since August, with a total of nine testing positive.

The agency announced that as many as 14 cases of infection could have happened through sexual contact. So far, two cases have been confirmed.

The CDC has flagged more than 30 destinations as areas dangerous for pregnant women or women looking to become pregnant.
 
 
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CDC, NIH Plead for $$ to Fight Zika

Vaccine research jeopardized by lack of new money

  • by Shannon Firth 
    Contributing Writer

 

WASHINGTON -- Congress has yet to approve the supplemental funding public health officials say is vital to preventing the spread of the Zika virus, despite its rapidly growing presence in the U.S. territory of Puerto Rico.

Cases of Zika in Puerto Rico are doubling every week, CDC director Tom Frieden, MD, MPH, told a House panel Wednesday.

He noted that in 2014, within 8 months of the start of the chikungunya outbreak, one in four adults had been infected.

"If that pattern is followed with Zika, we could see hundreds of thousands of infections by the end of the year," Frieden said at a hearing of a House Energy and Commerce subcommittee.

With mosquito season starting in June, he continued, "there's a limited window of opportunity to take action, and he pointed out that Florida and Texas could begin to see disease transmission.

Although only about one in five people with Zika infection exhibit symptoms, there is growing evidence of a link between the virus and infant microcephaly.

There have also been reports of a link between Zika and Guillain-Barré syndrome in adults. A recently published study from an outbreak in Polynesia has found that nearly all patients who developed Guillain-Barré syndrome also tested positive for Zika virus.

Rep. Frank Pallone (D-N.J.) said Republican leaders recently rejected the Obama administration's request for more than $1.8 billion in emergency funding. Instead they directed public health agencies to divert "unobligated Ebola funds" towards Zika-related efforts.

Pallone called these actions "short-sighted" and argued that they would only exacerbate public health risks in the U.S. and abroad.

Frieden reminded the committee that "Ebola is not over." The CDC currently has more than 80 staff members in Africa actively tracking the disease, he noted.

To compensate for the lack of Zika-related research funding, Frieden told MedPage Today, "We're basically pulling money from anywhere we can," including research on dengue and tick-borne diseases, "and there are serious trade-offs to that."

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told the committee his agency is still conducting important Ebola research, including a vaccine study. Of the $238 million given to NIH for Ebola work, his agency has roughly $9 million left.

 

"We don't have any [substantial] Ebola money to switch over," Fauci said.

He told reporters that his agency's efforts to develop a Zika vaccine could come to a halt without supplementary funding.

In addition to the search for a vaccine, both the CDC and the NIH are working to develop a more specific Zika diagnostic test. That, too, could be in jeopardy without a new appropriation.

http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/56516

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GOP Congressmen Question The Need For $2 Billion To Fight Zika Virus

RAE ELLEN BICHELL
A microbiologist sorts mosquitoes collected in Hutchins, Texas, to test for Zika virus.

A microbiologist sorts mosquitoes collected in Hutchins, Texas, to test for Zika virus.

LM Otero/AP

Republican representatives continue to question the need for about $2 billion in emergency funding requested by the Obama administration to respond to the Zika virus.

Congressmen including Dr. Michael Burgess, R-Texas, asked in a hearing of an Energy and Commerce subcommittee Wednesday whether funds earmarked for combating the Ebola virus couldn't be transferred to the fight against Zika virus.

But federal health officials said there's only $9 million left of the original $238 million in funding the National Institutes of Health received for Ebola virus research.

"We don't have any really substantial money that's left on Ebola," saidDr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Taking that money away could cripple the effort to develop an Ebola vaccine and to continue studies on thousands of survivors in West Africa.

"Ebola is not over," said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention. "As of today, 84 CDC top staff are in West Africa responding to the Ebola outbreak. Last month, labs in West Africa tested approximately 10,000 samples for Ebola. It was only in January that we had the most recent Ebola case in Sierra Leone. So we're still actively responding and tracking."

Still, some remain skeptical of the need for emergency supplemental funding.

"You're asking us for more money and you're saying it's an emergency. I might believe you more that it's an emergency if you would be willing to say, 'And we really don't want you to go down there,' " said Burgess, referring to the fact that the CDC has not told travelers to avoid countries with Zika transmission.

At this point, the CDC recommends that women who are pregnant or who could become pregnant limit travel to places with ongoing virus transmission.

"We need to give people information and allow them to make the choices," said Frieden. The concern is primarily for developing fetuses. In most adults, the virus is brief and mild.

Based on other research on similar viruses, one scientist said, a woman would likely only have to wait four weeks after having the virus to conceive a baby without worrying about the potential effects of Zika on the fetus. "It's about the only good news here," said Dr. Jeanne Sheffield, director of the Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine.

In Florida, where the mosquito that transmits the virus is abundant, one company is gearing up to test genetically engineered mosquitoes.

When these genetically engineered mosquitoes mate with wild mosquitoes, the resulting offspring can't reproduce. Fewer Aedes aegypti mosquitoes means less chance for Zika to spread.

Dr. Luciana Borio, acting chief scientist at the Food and Drug Administration, told the subcommittee that a British company, Oxitec, has done extensive field testing of the mosquitoes in Brazil, the Cayman Islands, Panama and Malaysia. They're now preparing for a test in Key Haven, Fla.

"What we don't know right now is where the public stands," Borio said. "So, what I can tell you right now is we are prepared to move very quickly on this."

As Shots has reported, despite aggressive efforts at mosquito control, which do not yet include genetically engineered insects, the Florida Keys Mosquito Control District has only been able to halve its population of Aedes aegypti.

"The data seems to be promising in terms of reducing the mosquito populations in those small field trials and we are greatly expediting the process," Borio said.

The trial in Florida can only start after a period of public comment on the potential environmental impact of releasing genetically modified mosquitoes. After the test, Oxitec would then need to get FDA approval for further use.

http://www.npr.org/sections/health-shots/2016/03/02/468936361/gop-congressmen-question-the-need-for-2-billion-to-fight-zika-virus?utm_source=twitter.com&utm_campaign=health&utm_medium=social&utm_term=nprnews

 

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