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Zika Battle Underscores Need For A Robust Public Health System

The Aedes aegypti mosquito is the only type known to transmit Zika virus.

There have been 17 cases of Zika infection in Kansas since the virus first appeared in the Americas last year.

All of the Kansas cases involved people who contracted the disease while traveling in countries with more tropical climates. Now, state health officials are mounting a campaign to prevent Zika from gaining a foothold here.

The good news: Sustained local transmission of the virus—infected mosquitoes biting people in Kansas—is not very likely for now, according to state epidemiologist Charlie Hunt.

“We just don’t have the weather here and the ecology here to support the Aedes aegypti mosquito," he says.

The Aedes aegypti is the only type of mosquito known to transmit Zika. Four out of every five adults who get infected with Zika won’t have any symptoms. But Hunt says the virus poses a serious risk to unborn children whose mothers become infected during pregnancy.

Credit Courtesy Kansas Department of Health and Environment
State epidemiologist Charlie Hunt works in his office.

“This is the first virus in about 50 years or so to be associated with a serious birth defect," he says. "Microcephaly has been the most noticeable birth defect that’s been associated with Zika virus, but having said that, we’re still learning a lot about this virus, and there are probably other birth defects that are associated with it.”

Microcephaly causes brain damage in babies, and prevention is the only effective way to deal with it. That means mosquito control is crucial. So, Hunt says, the state is launching a campaign to educate Kansans about how to prevent them from becoming a bigger problem.

“Part of our educational campaign will be educating people on how to get rid of standing water that’s around their house, so it’s waste tires, it’s flower pots, it’s pet dishes that are outside," he says. "We don’t want those standing there and allowing for mosquitoes to breed.”

Educational efforts are already underway, but a more intensive campaign is planned for next spring. It’s one of the activities that will be funded by the nearly $1.2 million Kansas is getting from the federal government to fight Zika. The money will also be used to improve communication between state and local health officials and for testing people who may have been exposed to Zika.

Hunt says the idea is to use the federal money in ways that will help the state respond not only to Zika, but to other health threats in the future.

Public health consultant Shirley Orr says that money is urgently needed. She says the public health system in Kansas and across the country is eroding.

“The last time that we had a significant infusion of resources—dollars—into public health really was with bioterrorism preparedness, as it was called at the time," she says. "Of course it waned away over the period of several years. It’s hard to sustain capacity when you have those drastic ups and downs in funding.”

After seven months of political bickering, Congress finally passed and the president signed a bill providing $1.1 billion in emergency funding for the fight against Zika.

Rich Hamburg, the interim president and CEO of the nonprofit public health advocacy group Trust for America’s Health, says it’s only a down payment on what will be needed.

“It’s a long time coming, but it’s not a longtime investment," he says. "This does not appear to be an outbreak that’s going away, so we’re going to have to have this debate again, with a new president and a new Congress.”

Hamburg says Kansas ranks 39th out of the 50 states and the District of Columbia in the amount of federal money going to public health, and only 47th in terms of state dollars. He sees a tendency to lurch from crisis to crisis, rather than maintaining a high level of preparedness.

“I think that’s the key thing, not let our guard down, and make sure that we’re adequately investing on an annual basis," Hamburg says.

Because whether it’s Zika, Ebola, pandemic flu—or something as yet unknown—Hamburg says the public health system is the first line of defense.