To prevent another epidemic, look beyond Zika

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Last year, when the Zika virus started hitching rides on travelers, many Americans began to realize it posed a risk to the United States. Then the virus began spreading from person to person, with the first documented case of a traveler transmitting the disease drawing headlines in February. Now, the virus is homegrown. 

Appearing in southern Florida in July, and in Texas just this week, cases of Zika that could only have emerged from within this country show the virus has been spreading locally.

{mosads}While the virus can be devastating, and in rare cases fatal, it’s not the deadliest mosquito-borne disease our nation is facing. Most of the cases are mild or asymptomatic. However, the recent congressional appropriation to fight Zika will help the nation mount a complete response, and in so doing, help us fight a host of illnesses that are migrating north with their mosquito hosts.

Zika’s spread raises alarm for what may come

Along with other infectious disease specialists, I’ve closely followed the spread of Zika here in Florida. At Orlando Health, Zika screening is now integrated into our emergency response and obstetrics procedures, building on existing efforts to monitor disease outbreaks and coordinate with regional and federal partners.

While we are quickly learning Zika’s dangers, including the fact that it can spread through sexual transmission, many questions remain. Globally, the Zika virus continues to be a threat that travelers are facing due to the explosive spread some countries have experienced, and caution is critical. However, panic is not, and can distract people from threats posed by even deadlier infectious diseases.

Some, like yellow fever, are of serious concern to travelers, but not present or spreading in the United States. Others, like malaria, was once a threat here, but it was long ago eradicated – though warming temperatures are raising the risk for their return. Dengue fever and chikungunya, continue to be a threat to our country since cases continue to occur in other countries and the pattern of transmission is similar to Zika: The Centers for Disease Control and Prevention (CDC) recorded its first local transmission of Chikungunya in the continental United States in 2014, also in Florida.

Fortunately, many tools for fighting Zika also work for other mosquito-borne threats. For example, a significant amount from recent Congressional appropriations will go to mosquito control and surveillance, including helping states prepare for Zika and respond to outbreaks.

With mosquitoes able to carry multiple diseases — in some cases, at the same time — there is no doubt of the broader impact from such efforts.

Additional funds will target development of new vaccines and diagnostics. While those will specifically address Zika, some of the new treatments and discoveries may prove effective far beyond that one virus.

Some funds will also target programs overseas, which in an era of rapidly spreading contagions is fundamental to preventing epidemics on our shores. Even if eradicated here, Zika remains a threat as long as there is active transmission in other countries. Those resources are almost certainly going to combat some of the world’s deadliest diseases, as the language specifically states the funds will support “related health conditions” and other vector-borne diseases.

Attention, not fear

Such coordinated actions are strengthening our national response to Zika, one that may become a modern model for fighting any infectious disease outbreak.

While the risk of widespread local transmission of Zika virus remains low, it is certainly a threat — particularly for pregnant women or women who may become pregnant. Each of us can do much to prevent Zika infection — the CDC has good guidance — and to avoid the host of other infections that threaten adults and newborns, alike.

However, we must also remain informed, active, and attentive to evolving risks. Our hospital, along with others in the region, have done much to respond to Zika, and as once-tropical diseases continue to migrate north, hospitals nationally should consider updating their procedures and protocols. Infectious diseases can be incredibly difficult to detect, and even harder to control — they demand vigilance from us all.

The nation should closely watch the spread of Zika as more than an immediate challenge. Instead, we must also see this for its lessons, a warning that we need to pay close attention to prevent even more dangerous outbreaks from taking hold.

Dr. Antonio Crespo, MD is the Chief Quality Officer at the Dr. P. Phillips Hospital at Orlando Health and is a clinical instructor at Florida State University’s College of Medicine. He is a board certified infectious disease specialist focused on helping patients afflicted with a range of illnesses including Zika, MERS, staph, malaria, and HIV.


 

The views expressed by contributors are their own and not the views of The Hill.

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