Oh Good: Congress Can’t Even Agree to Protect the US From Zika
Mosquitoes don’t wait for Congress. But mosquito control programs? Public health departments and the Centers for Disease Control and Prevention? They do have to wait for Congress, where Republicans are currently holding up emergency funding for Zika. As the weather warms, ever more Aedes aegypti mosquitoes will hatch along the Gulf Coast, and some of them are likely to spread Zika, which the CDC this week officially linked to serious birth defects like microcephaly.
But that has not jolted Congress into action. While the legislature stalls, the White House has appropriated $589 million of leftover money from the Ebola outbreak response to fund Zika. “The toxic relations between Congress and the White House could create a crisis,” says Peter Hotez, a tropical disease expert at the Baylor College of Medicine. The House did pass a measure to stimulate Zika vaccine research in April, but that will have zero impact on infections in the short term. Local mosquito control programs would have the most immediate impact against Zika, but they have been chronically underfunded in recent years. That does not bode well for the unique challenge of A. aegypti.
Unlike most mosquitoes that bite humans, A. aegypti like to linger indoors (rather than out) and fly around during the day (rather than dawn or dusk). Going out with a truck to spray neighborhoods won’t kill them off. Instead, old tires, upturned flower pots, empty cans—anything that can hold water for mosquito larvae—need to be eliminated house by house. Experts think Zika won’t spread as widely in the US as it did in South America because of widespread air conditioning and window screens, but it will likely hit the hardest in poor neighborhoods along the Gulf Coast.
A substantial chunk of the $1.8 billion of requested federal money stuck in Congress is supposed to go to boots on the ground to deal with A. aegypti. “Because that’s something that every state lacks,” says Frank Welch, medical director of the Louisiana Office of Public Health. “If you make them pass that funding package,” he adds, “I would be a very happy man.” Mosquito control departments are funded at the local parish level, and not all parishes even have dedicated mosquito abatement staff in Louisiana. The state is also dealing with severe budget woes, so the state government is in no position to dole out extra mosquito control funding.
Even with the money and infrastructure, mosquito control inspectors will face challenges if they want to go door-to-door. From 2009 to 2011, Key West, Florida had an outbreak of dengue, which is also spread by A. aegypti. Two dozen mosquito inspectors went from house to house, even scaling fences if residents weren’t home. They eventually contained the outbreak, but the intensive program was expensive. And Key West is just six square miles—imagine having to do that across the entire state. “If you gave me the 82nd Airborne at my disposal, I think I would have a rough time cleaning up,” says Walter Tabachnick, a medical entomologist at the University of Florida.
Aside from mosquito control, federal funds would also go toward increased surveillance of the Zika virus, which doesn’t sicken most people it infects. That makes tracking its spread difficult. Some state labs still don’t have the technical capacity to test for Zika, which has contributed to a backlog of hundreds at a CDC lab in Colorado.
One area of public health the federal funding request does not address is access to contraception—let alone abortion. In El Salvador and Colombia, the government has recommended women delay their pregnancies, but the CDC has never issued such a warning in the US. And the states where Zika is most likely to pop up—Texas, Louisiana, and Florida—have conservative legislatures and/or governors.
But even on the usually not very controversial topic of mosquito control and disease surveillance, Congress has been unable to get past the gridlock.