Just days after the Centers for Disease Control and Prevention (CDC) announced they’ve concluded that the mosquito borne virus, Zika, is the cause of microcephaly and other birth defects,  the head of the National Institute of Allergy and Infectious Diseases (NIAID), Dr Anthony Fauci appeared on Fox News Sunday with Chris Wallace this morning to talk about the Zika virus threat.

chartoftheWeek_040616finalThe questioning began with Wallace showing a CDC map that represents an estimated range of the mosquitoes that carry this disease in the United States this year (30 states). How serious is the threat in the shaded area basically the southern half of the country, this summer and — this spring and summer?

Fauci responded, “Well, it is likely we will have what’s called a local outbreak. Right now we have in continental USA we have over 350 imported cases, namely people who have traveled to a region, gotten infected and  came back. The concern is, once one comes back, would a mosquito, which you saw on that map, bite someone and then locally transmit it to someone who’s never left the country?

“It would not be surprising at all, if not likely, that we’re going to see a bit of that because we’ve seen similar types of things with other similar types of infection, like dengue. We’ve been able to control it so that it doesn’t become sustained or widespread. But the threat of at least having some local outbreak is likely, I would think. It’s up to us now to make sure when it happens we contain it.”

Wallace attempted to get clarification on the number of cases, Dr Fauci replied, “When we say local, we talk not about thousands of cases, we’re talking about scores of cases, dozens of cases at the most that historically with dengue were able to be contained. The other interesting thing that’s important is that it is sexually transmitted. And that’s another added dimension to it that is well documented now that it can be sexually transmitted. So there’s an issue there of someone who can transmit it to someone who’s not been bitten by a mosquito.

Now, the other thing you mentioned, very quickly, is that in addition to the Guillain-Barre , which is kind of a hypersensitivity reaction following the infection, we see that with things like influenza, we’re also seeing some disturbing indications that there are only individual case reports of significant neurological damage to people not just the fetuses but an adult that would get infected. Things that they call meningoencephalitis, which is an inflammation of the brain and the covering around the brain, spinal cord damage due to what we call myelitis. We’re starting to see them. We don’t know how frequent it’s going to be. So far they look unusual, but at least we’ve seen them and that’s concerning.”

Should women delay pregnancy? What should women do?, Wallace asked.

“Well, right now in the United States this should not be that concerning. We do not have local transmission here. So I think the idea about people in the continental United States delaying pregnancy is not — is not even an issue for discussion at this point, noted Fauci.

“The issue is, when you’re dealing in countries in which you have outbreaks like in South America, particularly Brazil or Puerto Rico, is a concern about what you might advise women. Right now the recommendation from the CDC are consult your physician about the kinds of options you might have. But a direct recommendation to delay has been given by countries. For example, El Salvador has actually said you should delay if you could. The confounding issue, Chris, about that, that’s in countries in which you may not have good access to birth control, and that’s one of the things that confounds that question.”

Image/Video Screen Shot
Image/Video Screen Shot

The discussion then got into politics and money. Wallace asked Dr Fauci about the request for the nearly $2 billion the Obama administration and public health officials requested. Basically, what’s it for, what are you going to do with it–here’s Fauci’s reply: “It’s $1.9 billion, $1.5 billion for HHS, which involves the Centers for Disease Control, particularly the Centers for Disease Control, about $800 million for Puerto Rico, for international but particularly for domestic. And that’s a variety of things, insect control, mosquito control. We at NIH are developing a vaccine which is very important. Public health measures. Educational campaigns. So it’s been delineated, the kind of things to do. And it’s divided among different agencies within HHS, as well as USAID and the State Department.”

Related: Marco Rubio supports $1.9 billion Zika funding proposal

The exchange continued:

Wallace:  “Now, congressional Republicans say that the plan that the administration has submitted so far is basically an outline. It’s not a detailed plan. And the head of the House Appropriations Committee, a fellow named Hal Rogers, Republican from Kentucky, he says that basically it’s a slush fund.”

Fauci: “Yes. Well, obviously, we disagree with that. I mean when we put together what we would be doing, and we’d be more than happy to go over even in more detail with them, but we have put together a — essentially a project by project approach of what we would do. I can tell you with regard to what I am responsible for, namely the development of a vaccine, we know exactly how we’re going to spend that money and hopefully, if successful, development of an — of a Zika vaccine.”

Dr Fauci went on to explain the urgency of the funding and if the money doesn’t get appropriated, “Then what we’ll have to do is to take things away from other very important areas and move it here, because we can’t stop. We can’t just not address this. This is really a very important thing. So we’ll have to be moving money around.”

Wallace closed with the following question: “Is this something that’s going to be with us for years?” Director Fauci said, “If it acts like a similar infection called dengue, which is transmitted by the same type of mosquito, exactly the same type of mosquito, and you look what’s happened in Brazil and in the Caribbean, dengue has been around for several years now. I don’t predict that this is going to be a one off and be gone. That’s the issue.

“The issue of being concerned and how concerned we are, you have to be prepared for something like this. It may be something that may be a small chance of a wide outbreak, but as long as there is the chance, if you get caught without being prepared, then you have a real problem. And that’s the reason why we emphasize the need, not for concern, but the need for preparation.”