Like a television series that ended the previous season with a cliffhanger, the U.S. Congress this week will pick up exactly where action froze in the early summer with a still unanswered February White House request for emergency Zika funding. But unlike the action in a television series, the public health impacts of the outbreak continued during the hiatus, with locally transmitted Zika in Florida prompting the Centers for Disease Control and Prevention to issue its first warning against travel to a destination in the continental United States, and with the continued global spread of the virus, including fast-increasing cases in Singapore, and, the addition in the Western Hemisphere of the Bahamas and the British Virgin Islands to the rolls of Zika-affected places, reflecting challenges to come.
Since Congress packed up for summer break leaving a stalled bill that would have funded some efforts, but at cost to others, public health research and responses also have continued, and they have yielded findings that further elucidate the impacts of the virus on babies born to women infected during pregnancy, and on members of the general population.
Last week, the CDC released a report of a study following congenitally-infected babies born with microcephaly that found more than 5 percent were also discovered over time to have suffered hearing loss with no other potential cause. The findings, indicating that babies infected with Zika during their mothers’ pregnancies should be checked and followed for signs of delayed and progressive hearing loss even if they do not initially appear to have been affected, adds to the known spectrum of possible effects of the virus in pregnant women.
In addition, correspondence published last week in the New England Journal of Medicine reports an analysis of Guillain-Barre syndrome incidence in countries experiencing active Zika virus transmission showing the numbers of patients with the paralyzing disorder rising from 100 percent (El Salvador) to 877 percent (Venezuela), and declines in the disorder following drops in transmission.
While both of these reports suggest additional costs of delayed responses to prevent the spread and impact of the virus, findings from a Liberian public health program responding to the impacts of the West Africa Ebola outbreak also suggest a continuing need to replenish funds that have been redirected from Ebola to Zika efforts during the months since the White House request. Following more than 400 men who had recovered from Ebola, the program found that traces of the virus can remain in the semen of male survivors much longer than previously thought — in one case at least 565 days. The program also indicated the preventive role of public health responses to that outbreak, finding that three quarters of the men who had reported sex without condoms when first enrolled later reported using condoms or abstaining from sex to avoid transmitting the virus.