The House Energy and Commerce Subcommittee on Oversight and Investigations held a May 23 hearing to examine the public health response to the Zika virus. The hearing focused on the findings and recommendations from a report issued by the Government Accountability Office (GAO) titled “Emerging Infectious Diseases: Actions Needed to Address the Challenges of Responding to Zika Virus Disease Outbreaks” as well as lessons learned from the government’s response to the spread of the Zika virus in 2016. A similar hearing was held March 2, 2016 [see Washington Highlights, March 4, 2016].
Testifying witnesses included: Luciana Borio, MD, acting chief scientist, U.S. Food and Drug Administration; Rick A. Bright, PhD, deputy assistant secretary, Office of the Assistant Secretary for Preparedness and Response; Anthony Fauci, MD, director, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH); Timothy Persons, PhD, chief scientist, U.S. Government Accountability Office; Lyle R. Petersen, MD, director, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases.
In presenting the findings of the report, Dr. Persons outlined the following unknowns about the Zika virus:
- How many individuals infected with Zika show symptoms versus those who do not show symptoms;
- What factors, including biological mechanisms, influence the spread of Zika between mother and fetus, and how geographic differences may impact the likelihood of transmission;
- How long the virus may remain present in various bodily fluids;
- What role prior exposure to the virus plays in the severity of infection and how likely is it that those individuals previously exposed with Zika will contract related viruses; and
- The full spectrum of outcomes associated with infection.
In his opening statement, Subcommittee Chair Tim Murphy (R-Pa.) commended various agencies on the quick response to the Zika virus, but warned that more remains to be done. He stated, “But despite these efforts, the unknowns of this disease still outnumber the knowns. We don’t know the actual number of infections in the United States. We don’t know the long-term impact of Zika infection during pregnancy on children born to infected mothers. We don’t know about the long-term impacts of infection on men, or on people who exhibit no symptoms of Zika. There are difficulties with the diagnostic tests we have in use today. And we don’t have good information or modeling on how the virus will spread this year, let alone beyond that.”
Ranking Member Frank Pallone (D-N.J.) reminded the subcommittee that proposed cuts to the Medicaid program [see related story] could have a direct impact on the ability of providers to adequately manage public health emergencies like Zika. He stated, “These steps to improve preparedness should also go hand-in-hand with strengthening our health care programs. We must ensure that individuals affected by Zika, particularly pregnant women and children born with microcephaly, have access to ongoing screening and health services. An integral part of that effort is the Medicaid program. Medicaid provides contraceptive services to help prevent Zika infection, and diagnostic services to detect infection. Medicaid is also a vital source of care for children born with special health care needs, like microcephaly. Today, Medicaid covers 1 in 3 children in the United States.”