- The Washington Times - Tuesday, August 2, 2016

A small Zika outbreak in Miami is raising the stakes in an election year funding fight on Capitol Hill, though disease trackers say the virus still poses a limited threat to the continental U.S. compared with elsewhere in the Americas, with local cases likely to max out in the “hundreds” through the rest of mosquito season.

The Centers for Disease Control and Prevention said the cluster of 15 cases in southern Florida was “not unexpected” and that Miami and the surrounding region in previous years have seen related viruses carried by the same mosquitoes, such as dengue and chikungunya.

Hawaii, Texas and Louisiana are also hot spots for the Aedes aegypti mosquito, but widespread use of window screens and air conditioning should protect most Americans from the type of outbreak that’s rocked Brazil and other Latin American countries.

“For these reasons, I do not expect there to be a large number of local mosquito-borne cases of Zika in the U.S., though smaller-scale outbreaks in certain states are highly likely,” said Amesh Adalja, senior associate at the University of Pittsburgh Center for Health Security.

Though travel-related cases had popped up for months, the first cases of mosquito-bite transmission were confirmed within the past week, marking a new phase to the disease.

Still, the feared explosive pandemic hasn’t reached deeply into the U.S., and researchers doubt it will.

Michael Kaufman, an associate professor of entomology at Michigan State University, said his “educated guess” would be 50 to 100 locally acquired cases on the mainland based on patterns of related viruses, while Chris Barker, an epidemiologist from the University of California, Davis, said he would expect additional cases to range from the tens to the hundreds as small outbreaks crop up here and there.

“I think there’s a tendency to think of Zika virus sweeping across the southern U.S., when in fact that’s not really how it works,” Dr. Barker said.

Scientists said it is hard to predict Zika’s potential punch, however, because this virus poses a series of wild cards.

The disease is new to the U.S., and four out of five people don’t exhibit symptoms, so their infections might not be reported. Most notably, the ultimate number of cases will depend on how quickly local teams can stamp out Aedes mosquitoes in areas with local transmission.

That’s already been a problem in Florida, where reported cases shot up from four on Friday to 14 this week.

“In Miami, aggressive mosquito control measures don’t seem to be working as well as we would have liked,” CDC Director Thomas R. Frieden said.

Hoping to win the battle, Miami-Dade County Mayor Carlos A. Gimenez on Tuesday authorized four weeks of aerial spraying in a 10-mile swath north of downtown, including the artsy Wynwood neighborhood, where state officials uncovered the cases. Teams also fanned out over the affected zone to distribute repellent and eradicate areas of standing water where mosquitoes can breed.

Dr. Frieden cited the “tough” nature of the Aedes aegypti in doubling down this week on President Obama’s request for $1.9 billion in emergency funding to combat the virus at home and abroad, while investing in vaccine research to prevent Zika-related birth defects that can cost $10 million over the lifetime of each child.

Zika is already swamping the island territory of Puerto Rico, where more than 5,580 people have been infected, including 672 pregnant women.

“I think the $1.9 billion request is absolutely appropriate,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Last I checked, Puerto Rico is part of the United States of America.”

Yet an election year standoff over Zika funding has largely shifted from the top line number — Mr. Obama’s $1.9 billion versus $1.1 billion, which even Senate Democrats find acceptable — to whether any new money should be tacked onto the deficit as emergency spending or taken from existing parts of the federal budget.

Republicans such as Sen. Roy Blunt of Missouri say their final offer of $1.1 billion — plus $589 million the administration already took from the Ebola fight and other accounts — approaches Mr. Obama’s request for nearly $2 billion, and that axing a long-term construction project in the White House plan would essentially make up the difference.

The office of Senate Majority Leader Mitch McConnell this week highlighted the Democratic Party’s own 2016 platform, which says they will “ensure that new spending and tax cuts are offset so that they do not add to the nation’s debt over time.”

Yet Democrats argue the White House shouldn’t be forced to choose which health priorities it tackles — Ebola or Zika — and that the Republican-drafted deal unnecessarily rolled back environmental protections and kept Planned Parenthood out of its birth control strategy.

The upshot is that Mr. Obama will have to use whatever money already exists, since Congress won’t return to Capitol Hill until September.

In the meantime, Republicans have urged the administration to reallocate the Ebola funds it’s already allocated to the Zika fight, while Democrats call on GOP leaders to cancel the August recess and renegotiate.

House Minority Leader Nancy Pelosi, California Democrat, said for “expectant mothers and families across America who are concerned about the threat of Zika, this Republican Congress must act.”

Analysts say the tumult will heighten awareness if more local infections arise, particularly among pregnant women, though Dr. Kaufman said the rhetoric around the risk had been overstated at times, particularly in his home state.

“For me, the hyperbole reached ridiculous levels when some folks in Michigan were advocating Zika-prevention strategies,” he said. “We have travel-related Zika cases in Michigan but almost zero chance of local transmission, because we don’t have the vectors and climate for sustained transmission.”

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