Puerto Rico, already reeling from a man-made financial crisis, could have “tens of thousands” of infections from the Zika virus, which has been linked to a serious birth defect, imposing an economic toll and forcing the island to import blood supplies from mainland donors, the Obama administration’s top scientists said Wednesday.
The territory is the only part of the U.S. where Zika has spread locally, instead of hitching a ride with travelers from Brazil or other parts of Latin America. The island’s warm ecology makes it susceptible to the Aedes aegypti mosquito, the wily species that carries Zika and blanketed the island with a related virus, chikungunya, in 2014.
President Obama has asked Congress for $1.8 billion in emergency funding to combat the Zika virus at home and abroad, citing its potential link to a sharp uptick in the rate of babies born in Latin America with abnormally small heads — a condition known as microcephaly. The request includes about $250 million for Puerto Rico’s Medicaid program to support pregnant women with a Zika diagnosis or who are at risk of infection.
It is one more task for a politically divided Congress that must decide in the coming weeks whether a financial control board or other drastic measures are needed to rein in Puerto Rico’s runaway debt, before the island is shut off from credit markets or dramatically curtails services for its 3.5 million inhabitants.
“Clearly, Puerto Rico has many challenges, and Zika is the most recent,” Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, said Wednesday in a briefing hosted by the Kaiser Family Foundation.
The Zika virus has spread to at least 30 countries, mostly in Latin America. Though it normally causes mild, if any, symptoms, scientists are using controlled studies to confirm a link between infection and babies born with microcephaly.
“It will tell us whether or not there is a connection and what the magnitude of the connection is,” said Dr. Anthony Fauci, director for infectious diseases at the National Institutes of Health.
Puerto Rico reported its first case of locally acquired Zika infection in November — an 80-year-old man — and tallied 30 lab-confirmed cases through Jan. 28, according to the CDC, which expects those figures to balloon.
“We think there’s the potential for many cases — tens of thousands or even more — of infection with the Zika virus in Puerto Rico, and with about 34,000 births per year, a risk of microcephaly there as well,” said Dr. Frieden, who noted that the birth defect can incur lifetime medical costs of $1 million to $10 million.
“In addition to the tragedy that this can represent, the economic costs can be quite high,” he said.
The outbreak also has implications for the island’s blood supply.
The Food and Drug Administration this week told people who had traveled to Zika-affected areas, people who had sexual contact with such travelers and those who had experienced Zika-like symptoms not to donate blood for four weeks. It also said areas reporting transmission — such as Puerto Rico — should obtain whole blood and red blood cells from places untouched by the outbreak.
Administration officials said Puerto Rico already imports much of its blood supply for transfusions from the mainland, so it is scrambling to develop an FDA-approved test to screen its local supply.
Until then, “in areas like Puerto Rico, that really have a significant ongoing problem,” blood will be imported from other parts of the U.S., Dr. Fauci said.
The CDC has dispatched two dozen workers to combat the virus in Puerto Rico, on top of roughly 50 employees it has stationed there to monitor dengue, a related virus carried by the Aedes aegypti mosquito.
The species is a day biter that likes to breed inside homes. Females, which do the biting, have developed a taste for humans and will bite as many as four people in one blood meal.
“Sometimes you’re [bitten], and you don’t know it. They are kind of deceptive,” said Alfonso Aguilar, who was born and raised in Puerto Rico and serves as executive director at the Latino Partnership for Conservative Principles, a Washington-based advocacy group.
Growing up, he would hear public service announcements that asked the citizenry to wipe out areas of standing water where the disease-carrying insects breed.
Mr. Aguilar said his high school friend, Bobby Lopez, liked to kill several mosquitoes and line them up on his desk while they studied — a warning for the other insects to stay away.
It didn’t work.