Health Care

UM Zika experts weigh ‘the cost of inaction’

cjuste@miamiherald.com

Educational volunteers, “Drain and Cover” posters and insect repellent giveaways don’t prevent the spread of Zika — people do.

That’s where doctors come in, tropical disease expert Dr. Paola Lichtenberger said Thursday during a Zika forum at the University of Miami. Experts need to hammer home the message that Zika is a big deal.

“This is a problem of all of the citizens of all the cities. It’s what you are doing every time you go outside,” she said. “We have pregnant women to protect. That is our responsibility and we need to take ownership of it.”

UM experts on tropical diseases, pediatrics, infectious diseases and obstetrics gathered Thursday for a panel on Zika, which has been transmitted by mosquitoes in two places in Miami-Dade County. The university is creating the Zika Global Network to share information and techniques with health workers in other countries hit by the virus, including Brazil.

Panelists focused on the science behind possible solutions to the virus. As cases multiply and Miami-Dade plans to start aerially spraying a pesticide — naled — over Miami Beach, some residents have been vocal with their concerns that the cure is worse than the disease.

The panelists offered a different view: “Everything in life is a risk balance,” said Dr. Christine Curry, a UM obstetrician.

For example, she said, driving to work in a car is a big risk, but the benefit of arriving at the destination makes it worth it. Drivers mitigate risk with safety features like air bags and seat belts.

In the case of Zika in Miami, officials insist naled is not toxic in small doses.

Read More: Is insecticide sprayed to fight Zika a risk for people and wildlife?

But protesters have raged at the idea of spraying the controversial pesticide designed to kill adult mosquitoes. The Centers for Disease Control and Prevention originally dismissed spraying Miami Beach because of the dense urban area and high-rise buildings but, with cases on the rise, Miami Beach plans to start spraying at 5 a.m. Friday.

But Curry, the UM obstetrician, said, “at this point, protecting pregnant women puts us in a place where using pesticide is a better risk balance.”

When the connection between Zika and microcephaly was first drawn, doctors assumed babies with normal-looking heads weren’t affected by the virus. Curry said growing evidence suggests infants with regular features can have hidden Zika effects, like calcification and water on the brain or eye problems.

She tells her patients everything she knows about the virus, but her advice comes with “a big asterisk.”

“I didn’t know all of this six months ago,” she said. “And what we know six months from now might negate all of this I’m telling you.”

Doctors will likely learn more in the next few months as the 80 pregnant women with Zika in the U.S. have their babies.

“What we do now impacts if we have five women or 50 women or if we turn into Puerto Rico,” Curry said.

Congress is considering a billion-dollar Zika funding bill that, if passed, would speed up research into a vaccine, testing and treatment — something UM doctors say they could use.

“We have the talents in research, but we’re unable to leverage them,” said Mario Stevenson, chief of infectious diseases.

Time spent arguing takes a toll on public health, the economy and “our collective sense of security,” said UM President Julio Frenk, the former health minister of Mexico.

“We seldom think of the cost of inaction,” Frenk said.

There are other obstacles to containing the disease, too. Zika tests are expensive, time-consuming and hard to get. Urine tests are easy and the results come back fast. But they only show whether the patient had Zika within the last two weeks.

The most effective test is when a patient’s blood is mixed with Zika antibodies. If the blood fights back, it means the person already had the virus and the body knows how to attack it now. The backlog in labs statewide means those results can take four to six weeks.

Gov. Rick Scott declared that all pregnant Floridians have access to free Zika testing, but Curry said “a mandate without resources is hollow.”

That’s where a rapid test would come in, said David Watkins, a UM pathology professor. He and Dr. Sylvia Daunert applied for a grant to work on creating a Zika test that would be as simple, effective and quick as a pregnancy test. They hope to develop an antibody-based test that would tell whether a patient had been exposed to the virus or had it.

Florida health officials reported no new local Zika infections on Thursday but 12 additional travel-related cases, including three in Miami-Dade, two in Alachua, one in Marion, one in Orange, one in Palm Beach and four involving pregnant women.

A total of 744 people in Florida have contracted Zika this year, according to the health department, including 604 travel-related infections, 56 local cases and 84 pregnant women.

Miami Herald staff writer Daniel Chang contributed to this report.

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